ASTROLOGY REPORTS APPLICATION FORM

           (Please use separate forms for ‘Friends and Lovers’ compatibility reports & ‘Location’ Astrology reports)

Please print off this form and complete clearly in BLOCK letters.

Please enclose cheque/postal order/international money order, made payable to L. Fleet

                      in UK pounds sterling (£) and send to:   

Mr. L. Fleet

3 Bristol Hill

Brislington

BRISTOL

BS4 5AA

UNITED KINGDOM

                                                                                                  E: lenadjutor@lenastrol.co.uk  

 www.lenastrol.co.uk

                         

NAME & ADDRESS TO WHICH REPORT IS TO BE SENT:

TITLE:

INITIALS:

SURNAME:

ADDRESS:

 

 

POST CODE:

E-MAIL ADDRESS:

TEL. No:

 

 IMPORTANT Please read the following notes before completing the remainder of this form:

Please do not guess times of birth, it is important that the time is as accurate as possible,

( preferably within + or – 10 minutes ).

For midday birth enter ‘NOON’.

For midnight birth, enter ‘00.00AM’ for start of day or ’11.59 PM’ for end of day.

Give times in local clock time, i.e. time on clock.

If birthplace is small, also please provide name of nearest town.

Please allow 14 days for delivery.

 

A: Astro*Talk  £18   B: TimeLine  £19     C: Child*Star   £15     D: Opportunities  £15

 E: Biorhythms  £11

SPECIAL OFFER: A + B:  £31 (Post free on all reports).

 

Only date of birth is required for E: Biorhythms.     

 

    CHRISTIAN NAMES:

    SURNAME:

    SEX M/F:                                                                                         

    BIRTH DATE (DAY/MONTH/YEAR):                       

    TIME OF BIRTH (HOUR/MIN):

    AM OR PM:

    BIRTHPLACE, COUNTY, REGION & COUNTRY:

    CIRCLE REPORTS REQUIRED:  A     B     C     D     E                COST (£):

  

 

    CHRISTIAN NAMES:

    SURNAME:

    SEX M/F:                                                                                         

    BIRTH DATE (DAY/MONTH/YEAR):                       

    TIME OF BIRTH (HOUR/MIN):

    AM OR PM:

    BIRTHPLACE, COUNTY, REGION & COUNTRY:

    CIRCLE REPORTS REQUIRED:  A     B     C     D     E                COST (£):

 

    CHRISTIAN NAMES:

    SURNAME:

    SEX M/F:                                                                                         

    BIRTH DATE (DAY/MONTH/YEAR):                        

    TIME OF BIRTH (HOUR/MIN):

    AM OR PM:

    BIRTHPLACE, COUNTY, REGION & COUNTRY:

    CIRCLE REPORTS REQUIRED:  A     B     C     D     E                COST (£):

 

    CHRISTIAN NAMES:

    SURNAME:

    SEX M/F:                                                                                          

    BIRTH DATE (DAY/MONTH/YEAR):                       

    TIME OF BIRTH (HOUR/MIN):

    AM OR PM:

    BIRTHPLACE, COUNTY, REGION & COUNTRY:

    CIRCLE REPORTS REQUIRED:  A     B     C     D     E                COST (£):

 

    CHRISTIAN NAMES:

    SURNAME:

    SEX M/F:                                                                                         

    BIRTH DATE (DAY/MONTH/YEAR):                       

    TIME OF BIRTH (HOUR/MIN):

    AM OR PM:

    BIRTHPLACE, COUNTY, REGION & COUNTRY:

    CIRCLE REPORTS REQUIRED:  A     B     C     D     E                COST (£):

 

    CHRISTIAN NAMES:

    SURNAME:

    SEX M/F:                                                                                          

    BIRTH DATE (DAY/MONTH/YEAR):                       

    TIME OF BIRTH (HOUR/MIN):

    AM OR PM:

    BIRTHPLACE, COUNTY, REGION & COUNTRY:

    CIRCLE REPORTS REQUIRED:  A     B     C     D     E                COST (£):

 

                                                                                                    TOTAL COST (£):  

 

NOTE!: If B: ‘TimeLine’ or  D: ‘Opportunities’ are selected, please provide the person’s current town, county and country  if different to mailing address given above, (this is for astrological calculation purposes).

If you should experience any problems in printing this form, please E-mail or write to me & I will

send an application form to you by E-mail or post, (whichever is most suitable for you).

 

 

 

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