Item #________ Description_________________________Size, Color,
Etc.___________________ Price______
Item #________ Description_________________________Size, Color,
Etc.___________________ Price______
Item #________ Description_________________________Size, Color,
Etc.___________________ Price______
Item #________ Description_________________________Size, Color,
Etc.___________________ Price______
Item #________ Description_________________________Size, Color,
Etc.___________________ Price______
Comments___________________________________________________________________________________
Personal Information
This is the address to which your receipt will be sent, and also the address to which
products will be shipped unless otherwise specified below.
Name_______________________________________________________
Address_______________________________________________________
City_________________________ State __ Zip ________________
Phone_______________________________________________________
E-Mail Address _______________________________________________________
Shipping Information (Optional)
Only complete this area if you would like the products to be shipped to an address
other than the one listed above (i.e. a gift).
Name_______________________________________________________
Address _______________________________________________________
City_________________________ State __ Zip ________________
Credit Information (Required)
Select your credit card type:
Name as it appears on card _________________________________________________
Credit Card Number____________________
Expiration Date (mm/yy)__________
Phone Orders: 1 (800) 453-8788 (VISA/MC/DISC/AM EXPRESS)
Fax Orders: 1 (503) 212-8689 (VISA/MC/DISC/AM EXPRESS)
Snail Mail:
Ole Smoky General Store, Inc.
259 Yacht Club Lane
Andersonville, Tennessee 37705
Make checks payable to: Ole Smoky General Store, Inc.