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Name:

Address:

 

 

Home Tel: -----------------------------------------------------Mobile:

 

Date of Birth: -------------------------------------------------Place of Birth:

Local Time: ----------------------------------------AM/PM---GMT Time :

Latitude: -------------------------------------------N/S------Longitude: ------------------------------------------E/W

If your question/s involve another person, please provide their details as well:–

Name: -------------------------------------------------Relationship to you :

Date of Birth: -------------------------------------------------Place of Birth:

Local Time: ----------------------------------------AM/PM---GMT Time :

Latitude: -------------------------------------------N/S------Longitude: ------------------------------------------E/W

Details of your question/problem:– (Separate sheet if necessary)

 

 

 

 

 

 

 

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Post to: Judy Hall, PO Box 5941, Wimborne, BH21 9AA. Allow up to 8 weeks for your reading.