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 _______ |
For relocation report, list up to 3 cities:
|
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 1.800.778.8490 THANK YOU! |
For relocation report, list up to 3 cities:
Please make check payable to: Earthwalk School of Astrology PO Box 171 Camden ME 04843 USA (Or call toll-free 1.800.778.8490 with your credit card order) |
Total
Report Price: $______________ + Postage: $______________ (U.S. customers--Add $4.60 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.