Flag Request Form

To send in a physical form in the mail, please fill out and print the following and send it into our office.
 
Date:
Name of Contact Person:
Address:
City: State:
Zip Code:
Phone Number:
 
Make all checks payable to: Keeper of the Stationery
 
Mail checks to:
Senator Amy Klobuchar
c/o Flag Requests Coordinator
425 Dirksen Senate Building
Washington, DC 20510
 
Prices INCLUDE Flying & Certification
($9.00 per flag) 		Prices do NOT INCLUDE Flying & Certification
Size Material Unit Price Qty
3' x 5' Cotton $39.80
3' x 5' Nylon $33.80
4' x 6' Nylon $41.80
5' x 8' Cotton $56.80
5' x 8' Nylon $48.80
    Total: $0.00
Size Material Unit Price Qty
3' x 5' Cotton $30.80
3' x 5' Nylon $24.80
4' x 6' Nylon $32.80
5' x 8' Cotton $47.80
5' x 8' Nylon $39.80
    Total: $0.00
 
Each flag will be accompanied with a certificate signed by the Architect of the Capitol certifying the date that the flag was flown over the United States Capitol and listing the name of the person/persons or organization for whom the flag was purchased. Please provide the following information, as applicable, so that we can include the appropriate information on the flag certificate. *Effective October 1st, 2018, the price of Flying & Certification was raised to $9.00 per flag.
 
1. Name of the person/organization as you want it to appear on the certificate:
 
 
2. If the flag is being flown to commemorate a special occasion, such as a retirement, graduation, anniversary, or birthday and if you want that occasion mentioned in the flag certificate, please list that occasion here:
 
 
3. If you want the flag flown over the Capitol on a specific date, please designate that date here:
 
 
If you want the flag to be mailed to an address other than the address of the contact person listed above, please provide the following information:
 
Name:
Address:
City: State:
Zip Code:
 
**Important**
Normal processing time for flags flown over the Capitol is 4 to 6 weeks. All prices listed are at cost, and no profit is incurred.