U.S. Senator Richard G. Lugar
Flag Order Form

Name __________________________________________________________

Address ________________________________________________________

City, State, Zip ___________________________________________________

Phone __________________________________________________________

E-Mail Address ___________________________________________________

Date Flag to be flown _______________________________________________
(If Applicable)

Flag to be flown for ________________________________________________

Occasion ________________________________________________________

Pricing:      
Flag Quantity Price Total
3x5 nylon   x $9.00 =
3x5 cotton   x $9.25 =
5x8 nylon   x $18.00 =
5x8 cotton   x $20.00 =
       
Shipping   x $4.00 =
Flying fee   x $4.05 =
Grand Total:     =

Check or money order should be made payable to Keeper of the Stationery and sent with completed flag form to:

The Honorable Senator Richard G. Lugar
Attention: Flag Coordinator
306 Hart Senate Office Building
Washington, DC 20510-1401

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