Fees: (Cash -- USD -- ONLY): $7.00 if order is to be sent to you by email. $10.00 if order is to be sent to you regular US mail. (Added $3 is to cover postage, paper, printing and handling.)

Name or Alias:____________________________________________________________

Birth: Month:____________________Date:________Year:__________

Time:______________ (Check One): AM [__] PM [__]

Birth City:___________________________________________________

State:_________________________________________________

Country:_____________________________________________________

Email (Required) if you want order sent to you by email, AND for notifying you when order is sent if by regular US mail:______________________________

Present Address (Required ONLY if your want order sent regular US mail):

Name:_______________________________________________________

Street or Post Office Box:_________________________________________

City:________________________________________________________

State:_________________________________________________

Zip Code:_____________________

[Note: Cash (USD) only -- no checks or M.O. Be sure cash is not visible through envelope.]

Mail to: Elbert Wade, 3847 FM 2423, Grapeland, Texas 75844
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