When You Were Born Astrological Order Form

PRICE: $ 46.94 US (plus shipping)

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Please enter the Recipient's Birth Information:

Name to be printed
on the front cover:

ex. #1: Bill Russell (For best results limit 30 characters max.)
ex. #2: Vanessa Williams
ex. #3: Mary Ann Banks

Name at Birth:
(If different than above)
Please specify what name
you would like printed
throughout in brackets.

ex. #1: William Lee Russell (Bill)
ex. #2: Vanessa R. Moore
ex. #3: Mary Ann Jones (Mary Ann)

Gender:

City of Birth*:

State/Prov. of Birth*:

Country of Birth*:

Date of Birth:

Time of Birth*:
(If known – otherwise
please enter 12:00 p.m.)

* Required for the professional astrological analysis.

Please enter your Personal Message here.

ex.: Thanks for being a great brother and friend! Love, Pamela
( Limit approx. 120 characters - click here for more samples )

Please select one of the following poems:

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Should you encounter any problems with the ordering
process, please email us at info@whenyouwereborn.com
or call 888-927-2676.