Kharizma Astrology - Order Form 6

Option 6 - Problem counselling:(1 main problem area investigated). Reading sent by e-mail - £15 sterling

Name
Title (Mr/Mrs/Miss/Ms/Other)
Sex	MaleFemale
Email Address - this is where the reading will be sent.
Full postal address including post code.

Name on reading
Title (Mr/Mrs/Miss/Ms/Other)
Sex	MaleFemale
Date of Birth
Place of Birth
Country of Birth
Nearest large town or city if not UK
Time of Birth	am pm
Is this time...	exact
	accurate to within half an hour
	approx
	not known
Tell me what your problem is. You can go into as much or as little detail as you wish. Use the box on the right.