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Horoscope Order Form
NAME:________________________________TELEPHONE:________________________
EMAIL ADDRESS:_____________________________Fax:________________________
PAYMENT METHOD:(Circle One) Mastercard - Visa - American Express - Discover - Check
CREDIT CARD NUMBER:______________________________EXPIRES:_____/______
SIGNATURE________________________________________DATE:_______________
We require the following:
NAME AS APPEARS ON CARD:_____________________________________________
BILLING ADDRESS 1:_____________________________________________
MAILING ADDRESS 2:_____________________________________________(Required)
CITY:______________________STATE:_________ZIP/POSTAL CODE:__________
Select the information you desire.
Item Price Quantity Total
Natal Wheel $ 5.95 _____ _________
Astrotalk $35.00 _____ _________
Timeline - six months $35.00 _____ _________
Timeline - one year $60.00 _____ _________
Friends Compatibility $21.95 _____ _________
Romance Compatibility $21.95 _____ _________
Texas residents add 8.25% sales tax _________
Shipping and Handling by Postal Service (Optional $5.00) _________
(E-mail no S&H charge) Grand Total _________
Allow two to four weeks for delivery.
All prices are US dollars.
The following information is required to calculate your
requested document. Birth Name:_________________________________Date of Birth:___________ Place of Birth:_____________________________Time of Birth:___________Time Zone:__________ Place of Birth needs to be city, state, and country. AM___PM___ The following information is needed to calculate a
friendship, business or romance compatibility. Please provide
information on the desired person with whom you want a
compatibility chart. Birth Name:_________________________________Date of Birth:___________ Place of Birth:_____________________________Time of Birth:___________Time Zone:__________ Place of Birth needs to be city, state, and country. AM___PM___
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