ALASKA STATE FLAG REQUEST FORM

Name and Phone Number of the person ordering the flag:
Name and mailing address to which the flag is to be shipped:
Size/Type of flag:	3ft. x 5ft. ..... $ 29.35 5ft. x 8ft. ..... $ 37.95	Quantity Sub-Total Total
Print out this form and make the check payable to:   "Legislative Affairs Agency"   and mail the check with this form to...   (Normal processing time is 6 weeks.)		Senator Alan Austerman State Capitol, Room 417 Juneau, AK 99801-1182   Phone: (907) 465-2487 Fax: (907) 465-4956