| Billing
Information |
 |
Send
To |
|
| Billing
Name: |
|
Name: |
|
| Address: |
|
Address: |
|
| City/
State/ Zip: |
|
City/
State/ Zip: |
|
| Phone: |
|
Phone: |
|
| E-Mail: |
|
E-Mail: |
|
| QTY
|
Description
|
Price
Each |
Total |
|
INDRA |
$15.00 |
$ |
|
Child
Astrological Report |
$15.00 |
$ |
|
Vocational
Guidance Report |
$12.00 |
$ |
|
Lovers
Compatibility Report |
$15.00 |
$ |
|
Friends
Compatibility Report |
$15.00 |
$ |
|
|
Ohio
Tax: |
$ |
|
|
Postal
Mail Shipping Charges
($10.00 per
report) |
$ |
|
|
E-Mail
Shipping |
FREE |
|
|
Total: |
$ |
Chart
Information
Chart One: |
|
Chart
Information
Chart Two: |
|
| Name: |
|
Name: |
|
| Date
of Birth: |
|
Date
of Birth: |
|
| Time
of Birth: AM or PM |
|
Time
of Birth: AM or PM |
|
| Location
of Birth: |
|
Location
of Birth: |
|
| Closest
Major City to Birth Location: |
|
Closest
Major City to Birth Location: |
|
Send Payment
and Chart Information to:
Carla Angel Edmister
192 Louise St.
Rittman, Ohio 44270
Questions
Email
astrologycenter@netscape.net
 |
