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    Astrology Soul Connection
    Astrology Readings

    Print this form & Mail or Fax it to us!
    Thankyou for choosing Astrology on the Web with Soul Connection. Your astrology report will arrive beautifully bound, with a clear interpretation and well-drawn chart. You should receive your order within 21 days.


    1. TO PLACE AN ORDER
    Telephone: If you are paying by credit card, we accept telephone orders 9am to 6pm AEST Mon-Fri. Please review the following and call +61 2 4861 3600 with your order.
    Fax: Alternatively you may send completed forms by fax to: +61 2 4861 2208
    Mail: If you are paying by check or money order, or wish to mail the order, complete and send, making payable to:
    • Digital Online Technology
      PO Box 1910
      Bowral NSW 2576
      Australia
    Internet/Web: We also offer an instant online ordering service at
    http://www.astrologycom.com/order1.html
    or click to contact us

    2. PRODUCT SELECTION
    Chart NameValueQtyTotal
    Birth Star (brief)$29.95[ Astrology Space]$_____
    Birth Star (standard)$79.95[ Astrology Space]$_____
    Birth Star (intensive)$129.95[ Astrology Space]$_____
    Modern Buckram Binding$70[ Astrology Space]$_____

    Personal Prediction (1 month)$33[ Astrology Space]$_____
    Personal Prediction (3 months)$99[ Astrology Space]$_____
    Year Ahead - 12 month forecast$350[ Astrology Space]$_____
    Modern Buckram Binding$70[ Astrology Space]$_____

    Relationship Analysis$99.95[ Astrology Space]$_____
    Soul Connection (standard)$59.95[ Astrology Space]$_____
    Soul Connection (intensive)$99.95[ Astrology Space]$_____
    Compatibility Report$49.95[ Astrology Space]$_____
    Combination Special$149.95[ Astrology Space]$_____
    Intensive Power Combination Special$249.95[ Astrology Space]$_____
    Modern Buckram Binding$70[ Astrology Space]$_____

    Total$_____


    3. PAYMENT INFORMATION

    [ Astrology Space] Check/Money Order (US$ Funds only)
    or
    [ Astrology Space] VISA [ Astrology Space] MasterCard [ Astrology Space] AMEX [ Astrology Space] Diners


    Credit Card Number: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

    Expiry: |__|__/__|__| Name on credit card: _____________________

    Billing Address: ___________________________________________________

    City: ______________ State: _____ Country: _________________ Code: __________

    Telephone: (____) _____ - _________ Email: _________________

    Signature: __________________________________ Date ________________

    4. DELIVERY INFORMATION
    [ ] Check this box if same as above

    Name: ____________________________________

    Address: ___________________________________________________________

    City: ______________ State: _____ Country: _________________ Code: __________

    Telephone: (____) _____ - _________ Email: ________________

    Any special instructions? __________________________________________

    5. READING INFORMATION

    Name of Person: _______________________________________________
    (Use the name as you wish it to appear on report)

    Date of Birth: Day |__|__| Month |__|__| Year |__|__| __|__|

    Please write name of month here in full: ______________________

    Time of Birth: |__|__:__|__| ____ (AM or PM?)

    Place of Birth: ________________________________

    State: ____________ Country: ____________________

    Gender: M / F     Nearest Major City: _________________


    6. ADDITIONAL INFORMATION FOR SPECIFIC READINGS
    a. For Forecast

    Start Date: Day |__|__| Month |__|__| Year |__|__| __|__|

    Please write name of month here in full: ______________________

    b. For Relationship Analysis & Soul Connection
    Name of Second Person: _______________________________________________
    (Use the name as you wish it to appear on the report)

    Date of Birth: Day |__|__| Month |__|__| Year |__|__| __|__|

    Please write name of month here in full: ______________________

    Time of Birth: |__|__:__|__| ____ (AM or PM?)

    Place of Birth: ________________________________

    State: ____________ Country: ____________________

    Gender: M / F     Nearest Major City: _________________

    c. Specific Questions to be answered with detailed interpretation or combination charts
    • 1 _______________________________________________

    • 2 _______________________________________________

    • 3 _______________________________________________

    7. ORDERING FOR MORE THAN ONE PERSON?
    If you are ordering readings for more than one person, please copy or print Section 5 and (if required) Section 6 for each person.

    8. PLACING YOUR ORDER
    Thank you for completing this form. Please make checks and money orders payable to Digital Online Technology. You may place your order by:
    Fax: +61 2 4861 2208
    Mail: Digital Online Technology
    PO Box 1910
    Bowral NSW 2576
    Australia
    Telephone: +61 2 4861 3600
    Call us Mon-Fri, 9am to 6pm AEST.
    website: http://www.astrologycom.com
    or click to contact us

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