BOTTOM-LINE HOROSCOPE READING ORDER FORM
* Required Fields
* 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
* Birth Time (+ AM or PM)
* City/State or Country/Region (or non-US)
* F = Female --- M = Male
* US Street or P.O. Box (or non-US)
* US Mail: City/State/Zip (or non-US)
* Email
* Printer [Yes or No]
* Contact Phone Number

------:: THANK YOU ::------
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