‘FRIENDS & LOVERS’ APPLICATION FORM

(Please useAstrology Reports application form for reports; A, B, C, D & E)

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

Please enclose cheque/postal order/international money order,

made payable to L. Fleet and send to:

 

Mr. L. Fleet

3 Bristol Hill

Brislington

BRISTOL

BS4 5AA

UNITED KINGDOM

E: lenadjutor@lenastrol.co.uk

www.lenastrol.co.uk

 

 

Should you experience problems in printing this form please E-mail or write to me and I will send you an application form by post or E-mail, (whichever is most suitable for you).

 

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 times are as accurate as possible, (preferably within + or – 10 minutes.)

For midday birth enter ‘NOON’.

For midnight enter ’00.00 AM’ 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.

 

‘FRIENDS & LOVERS’ cost per report:  £20 (Post free).

     

 FIRST PERSON:

CHRISTIAN NAME:

 SURNAME:

SEX M/F:                                                                                      

BIRTH DATE (DAY/MONTH/YEAR):                       

TIME OF BIRTH (HOUR/MIN):

AM OR PM:

BIRTHPLACE, COUNTY, REGION & COUNTRY:

 

 SECOND PERSON:

CHRISTIAN NAME:

SURNAME:

SEX M/F:                                                                                      

BIRTH DATE (DAY/MONTH/YEAR):                       

TIME OF BIRTH (HOUR/MIN):

AM OR PM:

BIRTHPLACE, COUNTY, REGION & COUNTRY:

                                                                                                                                                                                                   (£):

 

FIRST PERSON:

CHRISTIAN NAME:

SURNAME:

SEX M/F:                                                                                      

BIRTH DATE (DAY/MONTH/YEAR):                       

TIME OF BIRTH (HOUR/MIN):

AM OR PM:

 BIRTHPLACE, COUNTY, REGION & COUNTRY:

 

 SECOND PERSON:

 CHRISTIAN NAME:

 SURNAME:

 SEX M/F:                                                                                      

 BIRTH DATE (DAY/MONTH/YEAR):                       

 TIME OF BIRTH (HOUR/MIN):

 AM OR PM:

 BIRTHPLACE, COUNTY, REGION & COUNTRY:                                                                                                                                                                                                                        

                                                                                                                                                                                                   (£):

 FIRST PERSON:

CHRISTIAN NAME:

SURNAME:

SEX M/F:                                                                                     

BIRTH DATE (DAY/MONTH/YEAR):                       

TIME OF BIRTH (HOUR/MIN):

AM OR PM:

BIRTHPLACE, COUNTY, REGION & COUNTRY:

 

SECOND PERSON:

CHRISTIAN NAME:

SURNAME:

SEX M/F:                                                                                     

BIRTH DATE (DAY/MONTH/YEAR):                        

 TIME OF BIRTH (HOUR/MIN):

AM OR PM:

BIRTHPLACE, COUNTY, REGION & COUNTRY:                                                                                                           

                                                                                                                                                                                                        (£):

                                                                                                     TOTAL (£):

                       RETURN TO ASTROLOGY HOMEPAGE……………