INSTRUCTIONS: Please print this page, complete the form and mail it with your check or money order in US dollars (made payable to "Rex Wood") to:
FIRST AND LAST NAME: ___________________________________
MAILING ADDRESS: ______________________________________
CITY: ___________________________ STATE: _______ ZIP: _______________
EMAIL ADDRESS: _______________________________
Note: Email will only be used if we have questions about your order. Email addresses will not be sold or distributed to any other business or entity.
BIRTH DATE: ____________________
BIRTH TIME: _____________ AM / PM (circle one)
PLACE OF BIRTH (city and state, or city and country): _________________________
PLEASE SEND ME:
_____ qty. BIRTH CHARTS at $10.00 each = $________
_____ qty. COMPATIBILITY CHARTS at $10.00 each = $________
_____ qty. DAILY TRANSITS at $5.00 each = $________
FOR COMPATIBILITY CHARTS ONLY!
PARTNER'S FIRST AND LAST NAME: ___________________________________
BIRTH DATE: ____________________
BIRTH TIME: _____________ AM / PM (circle one)
PLACE OF BIRTH (city and state, or city and country): _________________________
FOR DAILY TRANSITS ONLY!
DATE (month, day, year): ____________________
Your publication will be bound in a clear plastic cover with a full color title page. Please allow 1-2 weeks for delivery via U.S. mail.