IN-DEPTH NATAL HOROSCOPE READING
NON PAYPAL ORDER FORM

[ * Required Fields ]]
* Select: In-Depth Natal Horoscope
* Select Media (recording) Preference: CD Cassette Tape
* Select Payment Preference: Check Money OrderOther
[You will receive payment instructions by email.]
* Name: First + Last
* Birth: Month/Date/Year
name * Birth Time (+ AM or PM)
* City/State or Country/Region
* F = Female --- M = Male
Next two entry boxes are for US mail addresses ONLY
Non US MUST type 'X' in BOTH boxes below -- so form can be submitted

* US Mail: Street or P.O. Box
* US Mail: City/State/Zip
NON US ADDRESSES ONLY
. Please separate each line of address with a */ (slash)

  Non US Address - Box will Expand
* Email
Printer? [Yes or No]
* Contact Phone Number(s)

Please type any notes/comments/questions or requests below:
Optional, but adding comment(s) now can tend to enhance your reading,
especially as related to main reason(s) you desire your horoscope read.
--------:: THANK YOU ::--------