FLAG REQUEST FORM

Name of the person or group to receive the flag:
Special message to be printed on the certificate:   Please, type or print clearly, and make it brief...
Date flag should be flown:
Date flag needed by:
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:	3x5 Cotton $ 16.40 3x5 Nylon * $ 14.90 4x6 Nylon $ 18.51 5x8 Cotton $ 28.23 5x8 Nylon $ 24.35 Prices effective Jan 1, 2000	* Please Note:   Flags are complimentary (free) for military retirements, boy/girl scout awards, and schools. Due to the large demand, complimentary flags are limited to 3x5 Nylon flags only.
Please make the check payable to:   "Honorable Don Young Office Supply Account"   and mail the check with this form to...   (Normal processing time is 6 weeks)		Congressman Don Young 2111 Rayburn HOB Washington, DC 20515   PH: 202-225-5765 FX: 202-225-0425