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Astrological Order Form for
Printout Reports

Total Enclosed Amount ________________

Please print or copy this form
and send it with a money order
or check enclosed in US Dollars.

PLEASE PLACE AN X OR
A CHECK MARK
BEFORE YOUR CHOICES

NOTE! Many states have more than one city
with the same name.
Like Brooklyn, New York.
Surprise, there is more than one
Brooklyn, New York
and more than one Burbank, California.
SO PLEASE, PLEASE TELL ME THE COUNTY
YOU WERE BORN IN.....

PLEASE INCLUDE A CONTACT PHONE NUMBER

TO REACH YOU: AREA CODE (________) _____________________

Basic Starter Birth Horoscope
$29.95 + $3.00 S&H Total $32.95

Three month full transit printout
$29.95 + $3.00 S&H Total $32.95

Six Month Mars and Hard Outer Planet Transit Report
$29.95 + $3.00 S&H Total $32.95

Astrological Lovers Compatibility Report
$29.95 + $3.00 S&H Total $32.95

Astrological Lovers Edge Report
$29.95 + $3.00 S&H Total $32.95

Mailing Name _______________________________________________

Mailing Address _____________________________________________

City ________________________________ State ________ Zip___

Name #1 _____________________________________________________

Birthdate (month, day, year) ____________________________________

Birth Place (City, County,State) ________________________________________

Birthtime__________ Pl


Please circle AM or PM. Pl

Name # 2_______________________________________________

Birthdate (month, day, year) ____________________________________

Birth Place (City, County,State) ________________________________________

Birthtime__________ Pl

Please circle AM or PM. Pl

PLEASE IF YOU HAVE ONE AN E-MAIL ADDRESS:_____________________________________________