Earthwalk School of Astrology

Astrology Report Order Form

 

Today’s Date ___________________

Person placing order/ship to information: Name ________________________________________________

Address ______________________________________City ___________________ State ____ Zip________

Phone (in case we need clarification of your order) (_____)________________________________________

 

Reports ordered for:

Type of report ordered

Pricing
Person 1 (Please print)

Name______________________________________

Birth date:

Mo. ____ Day ____ Yr. (4digits) _________

Birth place city________________________

State ________

Time of birth _____________ AM or PM (circle one)

For future forecast, indicate start date: __________________

For Solar Return report, indicate city of residence:

_________________________ State _______
  1. _________________________
  2. _________________________
  3. _________________________

For relocation report, list up to 3 cities:

  1. ___________________, State____
  2. ___________________, State____
  3. ___________________, State____

Discount schedule:

1 report--$25.00

2 reports--$47.50

3 reports--$67.50

4 reports--$85.00

5 reports--$100.00

6 reports--$112.50
Person 2 (Please print)

Name______________________________________

Birth date:

Mo. ____ Day ____ Yr. (4digits) _________

Birth place city ________________________

State _______

Time of birth _____________ AM or PM (circle one)

For future forecast, indicate start date: _____________

For Solar Return report, indicate city of residence:

__________________________ State _______

Questions? Call 1.925.323.9663

THANK YOU!
  1. _________________________
  2. _________________________
  3. _________________________

For relocation report, list up to 3 cities:

  1. ___________________, State____
  2. ___________________, State____
  3. ___________________, State____

Please make check payable to:

Earthwalk School of Astrology

604 21st Place, Santa Monica CA 90402 USA

(Or call 1.925.323.9663

using PayPal)

 Total Report Price:

$______________

+ Postage:

$______________

(U.S. customers--Add $4.80 for 1-2 reports, plus $2.00 for ea. add’l report over 2)

*International customers please email for postage amount.

TOTAL ORDER AMOUNT

$____________

 

 

To Order by Mail: Print and mail this order form with your check or money order in $USD.