 | Astrology Soul ConnectionPrint this form & Mail or Fax it to us!
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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:
//www.astrologycom.com/order1.html or click to contact us 2. PRODUCT SELECTION
3. PAYMENT INFORMATION
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
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:
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