MULTI-PERSON ORDER
 

Please fill out this part for person #1 (REQUIRED)

Birth Date: Name:  
Birth Time: Email:  
Birth City: Phone:
 
Birth State:
Mailing
Address:
 

OPTIONS:

Item 1:   Item 2:  

If "POWER PLACES" up to 3 Cities:

If "ASTROLOCALITY MAP":

1st City

2nd City

3rdCity

    By Country

By Continent

World Map

 

    

Please fill out this part for person #2 (if applicable)

Birth Date: Name:  
Birth Time: Email:  
Birth City: Phone:
 
Birth State: Mailing
Address:
 

OPTIONS:

Item 1:   Item 2:  

If "POWER PLACES" up to 3 Cities:

If "ASTROLOCALITY MAP":

1st City

2nd City

3rdCity

By Country

By Continent

World Map

 

    

Please fill out this part for person #3 (if applicable)

Birth Date: Name:  
Birth Time: Email:  
Birth City: Phone:
 
Birth State:
Mailing
Address:
 

OPTIONS:

Item 1:   Item 2:  

If "POWER PLACES" up to 3 Cities:

If "ASTROLOCALITY MAP":

1st City

2nd City

3rdCity

By Country

By Continent

World Map

 

    

Please fill out this part for person #4 (if applicable)

Birth Date: Name:  
Birth Time: Email:  
Birth City: Phone:
 
Birth State:
Mailing
Address:
 

OPTIONS:

Item 1:   Item 2:  

If "POWER PLACES" up to 3 Cities:

If "ASTROLOCALITY MAP":

1st City

2nd City

3rdCity

By Country

By Continent

World Map

 

    

  I understand & agree to the terms of service found here
Please enter any other comments or questions you may have here:
Up to 100 Characters only

 

 
 

2011 Dr. Lauren Meggison - All Rights Reserved