PRINTABLE ORDER FORM (FOR MAIL ORDER ONLY)

 SECTION ONE - CHILDREN'S REPORTS
 PARENT'S NAME: (MR/MRS/MS)
 ADDRESS:
 
 TOWN/CITY:  POSTCODE/ZIP:
 COUNTY/STATE:  COUNTRY:
E-MAIL ADDRESS (FOR E-REPORTS):
 TELEPHONE (IN CASE OF QUERY):
 CHILD'S FIRST NAME:  CHILD'S SURNAME:
  CHILD'S SEX (M/F):  DATE OF BIRTH (DD/MM/YYYY):
 TIME OF BIRTH (24 HR CLOCK):  PLACE OF BIRTH:

 CHILDREN'S REPORTS

 PRICE

 TICK AS REQUIRED

 TOTAL £
 ASTRUM CHILD REPORT  £20    
 ASTRUM CHILD REPORT E-MAIL  £15    
 ASTRUM CHILD REPORT PLUS  £24.99    
 ASTRUM CHARTWHEEL (BOUND)  £10    
 ASTRUM CHARTWHEEL (UNBOUND)  £7.50    
PRICES INCLUDE UK POSTAGE. (ADD £2 FOR EUROPE AND £3 FOR INTERNATIONAL).  
   SUB-TOTAL:  

 SECTION TWO - ADULT REPORTS
 FIRST NAME: SURNAME:
 ADDRESS:
 
 TOWN/CITY:  POSTCODE/ZIP:
 COUNTY/STATE:  COUNTRY:
 E-MAIL ADDRESS (FOR E-REPORTS):
 TELEPHONE (IN CASE OF QUERY):
 DATE OF BIRTH (DD/MM/YYYY):  TIME OF BIRTH (24 HR CLOCK):
 PLACE OF BIRTH (or nearest town if not on any map):

 ADULT REPORTS

 PRICE

 TICK AS REQUIRED

 TOTAL £
 ASTRUM ADULT REPORT  £20    
 ASTRUM ADULT REPORT E-MAIL  £15    
 ASTRUM ADULT REPORT PLUS  £24.99    
 ASTRUM CHARTWHEEL (BOUND)  £10    
 ASTRUM CHARTWHEEL (UNBOUND)  £7.50    
 PRICES INCLUDE UK POSTAGE. (ADD £2 FOR EUROPE AND £3 FOR INTERNATIONAL).  

 SUB-TOTAL

  
 You are deemed to have read and accepted our Terms & Conds.

 ORDER TOTAL

  
 
 

PLEASE DEBIT MY VISA/SWITCH/DELTA/JCB/SOLO/MASTERCARD:
 CARD NUMBER:
 NAME ON CARD:
 EXPIRY DATE:
 ISSUE NO. (SWITCH/SOLO):
 SIGNATURE:

 POST WITH YOUR CHEQUE OR CREDIT CARD DETAILS TO:

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