Arlington MA Rotary Flags for Heroes

					Rotary Club of Arlington PO Box 23 Arlington, MA 02476 arlingtonmarotary.com
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Fill in and Email Form:

1) Fill in the following information and click the Email to Rotary button.

2) On the next page, continue to PayPal by clicking the Donate button.

Last Name: *
First Name(s): *
Street Address: *
City/Town: *
State: *
ZIP Code: *
Phone: *
Email: *
The Name of the Hero you want on the flag pole:($40 per Entry)*:
Second Line for Hero (if desired):
Third Line for Hero (if desired):
To Be Paid by PayPal

* Required Information

For any questions on the above procedures, E-mail them to bill_hayner@comcast.net.

Thank you!