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FORM FOR ORDERING CHARTS

Please fill out the following form to order the product that you need. Only one product can be
ordered at a time. All data for constructing chart is necessary.
DO NOT FORGET TO MAKE PAYMENT AFTER SUBMITTING DATA

Your address and birth data is necessary for any product that is ordered.

Your Address:

First Name: Middle Initial:

Last Name:

Address:

House # & Street Name:

Apt.#: or P.O.Box:

City/Town: State/Province:

Zip Code: Country:

Your E-mail address: (Required)

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Personal information needed to construct chart:

Place of Birth: Town/City:
State/Province: Country:

Time: Hour & Min: am. or pm: Time Zone:

Month: Day: Year:

Source of Data: Choose one
Birth certificate: Family Info.: Not known:

If your are ordering a Horary Chart to answer a question or an Electional Chart for choosing a
good day for________? (Ex: wedding, buying a house, etc.), you must enter your question or query
below:

Your Horary Question or Electional Query:

YOU MUST PRESS THE SUBMIT BUTTON ABOVE BEFORE CHOOSING
ITEM AND MAKING PAYMENT BELOW.

After submitting form, please choose the item wanted by clicking in the box in front of
name of item and click on the grey button, "buy now". You will be making a payment thru PayPal,
a Secure Server. You can use a Master Card or Visa . You may also make payment with a money
order or a cashier check. Go to end of form for instructions on how to purchase products without
credit card.

PRODUCT LIST:

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_________________________________________________________________________________

________________________________________________________________________

ORDER BOOKS (Listed in Library )

(You must send us an e-mail listing the title/s that you wish to purchase first. We will send you
an e-mail to let you know if the book is for sale or not and the price).

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Payment Procedure without credit card.

Send cashier check or money order to:

        ASTROSCAPES
        P.O. Box 485
        Norwood, Ma. 02062-0485

      Print out this filled form for your record. Mail a copy of this
form with payment to the above address. You can also send it electronically
by pressing the submit button and send payment separately to the above
address. NO DELIVERY TILL PAYMENT IS RECEIVED!

     Thanks for your order. If you have any questions, please contact us by
pressing the e-mail icon below.

"To doubt the influence of the stars is to doubt the wisdom and providence of God".
Tycho Brahe (1546-1601)

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