| First
Name |
|
| Last
Name |
|
| E-mail |
|
| Address |
|
| City |
|
| State:
(eg: CA) |
|
| ZipCode |
|
| Country |
|
|
Telephone
|
|
| |
Birth
Information
|
| Select
One: |
Male
Female |
|
Date of Birth
|
|
| Time
of Birth |
Time Known
Time Unknown
Hour
Min
(AM/PM)
|
| Select
One |
Standard Time
Daylight Time
|
|
Place of Birth
|
|
| |
|
Your
Order: LIFE-SCAN: $47.00
|
Optional
charts, available with Life*Scan purchase: (all $10)
|
|
|
Your ideal lover's personality chart
|
|
|
The Inner Guide's chart. Very important for a person who wants to
do Inner guide meditation, in order to ensure you have the correct
Inner Guide and not a False Guide. |
|
|
Personality of your banker |
|
|
Personality of your neighbors |
|
|
Your mother's chart |
|
|
Your healer's personality chart |
|
|
Partner's personality chart(your shadow) |
|
|
Your sex partner's personality chart |
|
|
Your Boss or Father's personality chart |
|
|
Your ideal Friends personality chart |
|
|
Secret Ememy's personality chart
|
Credit
Card Information
|
| CardHolder
Name: |
|
| Card
Type: |
|
| Number:
|
|
| Expiration
Date: |
|
|
|
|
Please note: The $47 charge includes shipping and handling for
all orders within the USA and Canada. For orders outside of the
USA or Canada, a $10 shipping/handling fee will be added.
|