You may purchase your flag to fly in the event for $25.00.  The following may be completed and mailed to:  Loudon County Republican Party, P. O. Box 541, Loudon, TN 37774.  The form must be received by the party no later than June 7, 2010.

In “HONOR OF”_______________________________________________

In “MEMORY OF”_____________________________________________

Name of Purchaser to go on plaque                                                                    

Address of Purchaser_____________________________________________

Phone of Purchaser ______________________________________________

Payment of $25.00 payable to the Loudon County Republican Party

_________ Cash or ________ Check