HEMISPHERE ORDER FORM
Customer:
Name:
Street Address:
City, ST ZIP Code:
Phone Number:
Email Address
Qty	Color
	Slate
	Heather
	Nutmeg
	La-Z-Boy
Qty	Flooring
	Plank Wood Lino
	Ceramic Tile Lino
Qty	Cabinetry
	Palisades Cherry (Dark)
	Fulton Cherry (Light)
Qty	Model #	Standard Features
	F 336 QBUD
Qty	Option #	Description
	848	Twin La-Z-Boy Sofa w/ Hode-A-Bed (U-Dinette)
	830-1	Dbl. La-Z-Boy Sofa w/ Hide-A-Bed
	8014-2	Dbl. Air Hide-A-Bed
	8014	Twin Air Hide-A-Bed (U-Dinette Model)
	1011	Spare Tire & Carrier
	399	Skylight Over Tub
	122	Outside Shower
	868	Jiffy Sofa IPO Lower Bunk (All Bunk Slides)
	10094	Outside Kitchen
	358	"CSS" Cooler Slide System (Front Bed Units Only)
	1705	Ladder Only
	702	Freestanding Dinette (Std. 292FHDS, 292RLSS, 246RLBS, 316RKBS)
	804-2	Ceiling Paddle Fan w/ Wall Switch (Living Room 5th Wheels)
	1204	15" Tires w/ Aluminum Wheels
	4--1	15K A/C Upgrade
	184	Barstools (2)
	706	Counter Top Extension (L-Shaped Counters Only)
	1861-1	50 Amp Service w/Wire & Braced for 2nd A/C
	722	Additional Chair (246RLBS Only)
	902	Canadian Standards