Janet Driscoll Order Form


For each desired report, fill out this form selecting the report you would like to purchase. Print the form(s) and mail or fax to:

Janet Driscoll
52 TORQUAY ROAD
NEWTON ABBOT, DEVON, UK   TQ12 2HY


Phone: 01626 369656
Email:Revjanetdriscoll@aol.com

(If paying by cheque I except sterling only
Please make checks payable to J Driscoll

Astro Talk Professional   £25.00 
Friends & Lovers  £5.00 with Astro Talk (£10 if purchased later)  
Timeline one month day today   £5.00
Opportunities £5.00 with Astro Talk
( £10.00 if purchased later
Bio-writer   £5.00
Total Cost:


For all reports fill out just the birth data for One Person.
For Friends & Lovers fill out the two individuals involved).
[If ordering Friends & Lovers, select: Friends or Lovers ]

                                                       Birth Chart Information

Person 1 [Needed for all reports]

Name: (Last name, First)
Gender: Male Female
BirthDate:

Please enter actual time as per birth certificate:

BirthTime:
(most accurate report)

OR, if you don't know
your birthtime, Check here:


Birth City:
Birth State: (or Country)

Person 2 [Needed for all reports]

Name: (Last name, First)
Gender: Male Female
BirthDate:

Please enter actual time as per birth certificate:

BirthTime:
(most accurate report)

OR, if you don't know
your birthtime, Check here:


Birth City:
Birth State: (or Country)


Your Mailing/Contact Information:

First Name:

Last Name:

Address Line One:

Address Line Two:

Tow/City:

State:/County:

Post Code:

Email Address:

Tel No:
Mobile No:
Please add any additional information into the box below

 
 


Your order includes postage and will be processed as soon as possible but please allow 28days for delivery

 

 

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