STEP 1 - Personal Information Form

3 Easy Steps! 

You have selected a Relationship Reading:   

First, in order to process your order, we must have both you and your partners specific astrological and personal information in order to perform your "Personalized Readings". Your privacy is very important to us and will not be sold nor shared with anyone outside of this website.

You must enter all the information correctly to assure that your reading is accurate and that we may contact you in case there is additional information needed! Once all questions are answered.....

Click STEP 2 button ONE time  only  please.  Thank-you!

 

Your First Name  * Verification: Mandatory
 
Last Name  * Verification: Mandatory
 
Your Address (Current) * Mandatory
 

Your
City (Town, Locality) * Mandatory
 

Your
State (Province, Region, etc.) * Mandatory
 

Your
Zip Code  (Mail Code) * Mandatory
 

Your
Telephone (Area Code & Telephone No.) * Mandatory
 

Your
Email * Mandatory
 
Date of your Birth (example: 01/01/1966) * Mandatory
 
Time of your Birth (example 2:35 AM or unknown) * Mandatory
 
The City, Town, or Borough of your Birth  * Mandatory
 
The State of your Birth * Mandatory
 
Country of your Birth * Mandatory
 
Country you reside today * Mandatory
 

 

Sex
( Select One )
Male
Female

  

Marital Status
( Select One )
Single 
Looking 
Married 
Divorced

 


Now Enter Your Partners Information

Your Partners First Name   * Mandatory
 
Your Partners Last Name  * Mandatory
 
Date of your Partners birth (example: 01/01/1966) * Mandatory
 
Time of your Partners Birth (example 2:35 AM or unknown) * Mandatory
 
The City, Town, or Borough of your Partners BIrth  * Mandatory
 
The State of your
Partners Birth * Mandatory
 
Country of your Partners Birth * Mandatory
 
Country your Partner resides in  today * Mandatory
 

 

Sex
( Select One )
Male
Female

 

Marital Status
( Select One )
Single 
Looking 
Married 
Divorced

Additional Comments:


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