APPALACHIAN  LOG  HOMES  ORDER  FORM

Appalachian Log Homes, 11320 Station West Drive, Knoxville, TN 37934 USA
            phone: 1-865/966-6440      fax: 1-865/675-2662 

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                                           Quanity  Price Ea.   Total
------------------------------------       -------  ---------  ------- 
 Appalachian Log Home Color Catalog        _______  $10.00(US)  $_____


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                                               Grand Total(US) $______
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Today's Date ________________________________
                                                
Company Name _________________________________________________________

Name _________________________________________________________________

Physical or Shipping Address _________________________________________

City/State/Zip _______________________________________________________

Country (if other than US) ___________________________________________

Phone ____________________________   Fax _____________________________

Payment: (please check only one)     ____ VISA         ____ MASTERCARD        

    Account # ________________________________  Exp. Date ____________


Authorized signature _________________________________________________