Title: Mr. Mrs. Ms. Dr.
Name:    
Company: 
Address: 
City:     ST: International AE AP AL AK AS AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY  Zip:
Country: 
Home Ph:  Time to call: Weekdays Weeknights Weekend Days Weekend Evenings
Work Ph:  Time to call: Weekdays Weeknights Weekend Days Weekend Evenings
FAX:     
Email:   
          

My interest is in (check all that apply):
          Log Home 
          Bob Timberlake® Collection 
          Timber Frame 
          Hybrid 

I am planning to start construction in January February March April May June July August September October November December Unknown  of 2006 2007 2008 2009 2010 .

Have you purchased/selected a building site?  Yes No

If so, where is it located?
County/Parish:  ST: International AL AK AS AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY 

How did you hear about Hearthstone? Internet Search Timberlake Gallery - Lexington NC Southern Living Plans Post Card Other Mailing Referral-Friend/Owner/Professional Trade Magazine(s) Lifestyle Magazine(s) Wall Street JournalOpen House or Seminar Miscellaneous Advertisement Own a Hearthstone Home Other 

Comments: 

I would like to receive e-mail notification of new products, specials,
and monthly updates: Yes No

I would like to be notified of upcoming events (Open House, Seminar, etc.)
in my area: Yes No

I would like a sales representative to contact me:
Yes No

May we telephone you if we need clarification on your request?
Yes No