Astrology Cafe - Order Form

Your Details

Full Name:
Name on Birth Certificate (if different):
Gender:
Date of Birth:
Time of Birth:
	OR, check here if you don't know your birthtime.
City of Birth (the closest city will do):
State of Birth (US-born citizens only):
Country of Birth:

Check here if you require a Compatibility Reading, then fill out your partner's details below.

Your Partner's Details

Full Name:
Name on Birth Certificate (if different):
Gender:
Date of Birth:
Time of Birth:
	OR, Check here if you don't know your birthtime.
City of Birth (the closest city will do):
State of Birth (US-born citizens only):
Country of Birth:

Select your choice of readings:

		Western Character Reading.	Ł5.00
		Western Compatibility Reading	Ł5.00
		Oriental Character Reading.	Ł5.00
		Oriental Compatibility Reading.	Ł5.00
		Numerology Reading.	Ł5.00
		Total Order Value (UK Pound(£) Sterling)
		Your currency equivalent. Click here for a forex calculator.

Please note: UK-based buyers should enclose a cheque or postal order made payable to Judith Atherton (postage and packing is included in the prices above). Non UK-based buyers should enclose an International Money Order and include shipping costs to the value of £2.00 UK Sterling. Alternatively your purchase can be emailed to you anywhere in the world free of postal charge (see below). In all cases payments should be forwarded to:

1 Sussex Court,
Manor Way,
Elmer Sands,
Bognor Regis,
West Sussex,
England,
PO22 6LE.

Once payment has been received the order will be despatched immediately.

Please provide the following contact information:

Note: if you wish to have your Reading(s) posted to you then please provide address details. Alternatively, check here if you would like your Reading(s) emailed to you. If this is the case then only provide your email address below. In all instances your email address is required just in case you or your partner's details need to be clarified.

Street address:

Village/Town/City:
County (UK only):
State/Province (non-UK):
Country:
Zip/Postal code:
Work Phone (optional):
Home Phone (optional):
E-mail (required):

Do you have any other comments?