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Order Form

ORDERING INFORMATION
First Name:
Last Name:
Email Address: (Valid Email Address Required)
Comments: Special Instructions

BIRTH INFORMATION


Person #1
First Name:
Last Name:
Birth Date:
Actual time on birth certificate:
Birth Time: : :
OR, Check here if you don't know your birth time.
Birth Place City:
State:
Country:
Resident City, State: TimeLine Report
Gender:	*
* Friends & Lovers report.
For Astrology Readings Only: Recording preference? Cassette Tape Computer CD Mailing Address:
Astrology Reading: In Person/Telephone? In Person Telephone


Person #2
First Name:
Last Name:
Birth Date:
Actual time on birth certificate:
Birth Time: : :
OR, Check here if you don't know your birth time.
Birth Place City:
State:
Country:
Resident City, State: TimeLine Report
Gender:	*
* Friends & Lovers reports.
Choose:	*
* Friends & Lovers report.

Click SUBMIT ORDER and then RETURN HERE to make your payment using PAYPAL

Please CLICK the PAY NOW button above to make your payment.
Also, please total and ENTER THE AMOUNT OWING.
(Payment must be received before orders are processed).

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