Contact Information
Note: Your credit card statement will display the name Bambora for this payment.
Your Information
First Name:
  
Last Name:
  
Street Address for Flag:
  
City:
  
Postal Code:
  
Email:
  
Phone:
  
Are there underground sprinklers at the front of the yard?:
  
Is the flag a gift for someone?:
  
If it is a gift, enter their name:
Is the flag to honour a past or present member of the Armed Forces?:
  
Past or Present Member of the Armed Forces?:
Enter the rank, first name, and last name. Add $20 to the payment for the lawn sign that will be placed beside the flag pole:
How did you learn about our Fly the Flag with Rotary fundraiser?: