Pre-Flag Installation Questionnaire

Pre-Flag Installation Questionnaire

Please fill out this questionnaire to provide us with the necessary information for the safe and prompt installation of your Rotary flag.
Customer Information
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number (mobile preferred)
Please enter a valid phone number.
Installation / Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Installation Site Details
Type of Installation

ResidentialCommercial
Type of Property

HouseOfficeOther
Requested Installation Date

MonthDayYear
Date
Standard Installation location is near the roadway directly aligned with the front door of the main structure of the property. Please list any items of note that may be helpful when we call in UTILITY LOCATES or establish the sleeve location for the flag pole.
How would you prefer to pay?

I'd like to pay new with a card. ($1.80 card fee applies)Please INVOICE me later.

Credit Card Convenience: If you choose to use the credit card payment option below, there will be a $1.80 fee applied to the purchase to offset processing fees we incur. Thanks for your understanding.

My Products

Annual Flag Placement ServiceCovers placement and removal of American Flag at your location 5 holidays throughout one calendar year.

$51.80 Quantity
Item subtotal:$0.00

Total

$0.00

If you chose NOT to provide CARD payment on the previous page, you will receive an Invoice via email or mail addressed to the location of the flag placement.

PLEASE CLICK "SUBMIT" BUTTON EITHER WAY SO WE RECEIVE YOUR REQUEST TO RENEW THE SERVICE. THANK YOU.
Should be Empty:

Customer Information