arepnw.org Astrology Report Order Form

Association for Research and Enlightenment
Pacific Northwest Region
Astrology Reports Order Form

To order one or more Astrology Reports:

Fill out one form for each person for whom astrology reports are ordered.
Print the form(s) and mail with your check or credit card information to:

Pacific Northwest Region
C/O David & Mary Kralman
24502 SE 380th St.
Enumclaw, WA 98022

Note: The Shipping and Handling charge applies only to the combined total of all order forms.

For your security, this form is running only on your computer, and information you type in stays on your computer. There is no Submit button on this form, so nothing can be transmitted or intercepted over the Internet.

Mailing Address		Ship to address if different
Name
Street address
Address (cont.)
City, State Zip
Country
Home Phone
E-mail
Special instructions & comments

Astrology Charts For
	Person #1	Person #2
Name (last, first mi)
Date of birth (mm/dd/yyyy)
Time of birth (hh:mm:ss)
Birth City, State/Province/Country

Check the desired charts and enter other information as required
Chart Name	Price	Amount	Check	Other Information
Cayce Past Life Interpretation	$19.95	________
Basic Natal Interpretation	$9.95	________
Expanded Natal Interpretation	$19.95	________
Basic Life Themes	$2.95	________
Vocational Guidance Interpretation	$14.95	________
Hidden Messages	$9.95	________
Relationships between two people	$14.95	________		Fill in birth information for Person #2
Child interpretation Boy Girl	$16.95	________
Adult interpretationMan Woman	$19.95	________
1 month forecast (day by day)	$5.00	________		Please enter current residence (city, state/province/country) when ordering forecast
6 month forecast (day by day)	$15.00	________
12 month forecast (day by day)	$20.00	________
Relocation (4 locations)	$9.95	________		Relocation places (city, state/province/country)
Karmic Insight	$14.95	________
Reports total this form (1)		________
Sum of reports total all other forms (2)		________
Shipping & handling (3)	$2.00	________
Total before sales tax (1+2+3)		________
WA state residents add 8.4% sales tax		________
Total order		________
Please check method of payment
Check or money orderMastercardVisa
Card number	Exp. Date
___________________________ Signature

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