Internet Report and Chart Services Order Form
Mail, Fax, Phone or Email to: Astrolabe, Inc., PO Box 1750, Brewster MA 02631
FAX: (508) 896-5289; Orders/Information: 1 800 843-6682; E-mail: charts@alabe.com
Today’s date ___________________

Name _________________________
Address ________________________
_______________________________ City ________________State ______
Zip ______ Day tel./fax ____________
Email: _________________________

How did you find out about us? _______________________________

 Please ship reports for Name(s) # ___to:

Name _________________________
Address ________________________
_______________________________
City _________________ State ____
Zip _______

Please enclose a gift card signed:____________________________
Birth Data
Name #1 _____________________
Female Male
Date _________________________
Exact Time _____________ AM PM
Place __________________________ Starting Date for Report (where applicable) ___________________

Report/Chart Services Desired & Price
Birth Data
Name #2 _____________________
Female Male
Date _________________________
Exact Time _____________ AM PM
Place __________________________
Starting Date for Report (where applicable) ___________________		  Report/Chart Services Desired & Price
Birth Data
Name #3 _____________________
Female Male
Date _________________________
Exact Time _____________ AM PM
Place __________________________ Starting Date for Report (where applicable) ___________________		  Report/Chart Services Desired & Price
 [ ] Check/MO to Astrolabe enclosed.
[ ] MC [ ] Visa date _________
Card # _______________________
Signature _____________________

 Total for reports from a separate page $____
Subtotal $_____
5% Sales tax (if ordering from MA), $______
Shipping, per US address: $________
Surcharge for rush shipping $________
Total $________

TOLL-FREE ORDER LINE: 1/800/843-6682.
Please Have Your Complete Birth Data Ready When Ordering
(Date, Time and Place)

Shipping & Handling Charges: Chart calculations: $2;
Reports: $5 1st report, $1 each add'l. report.
Please allow up to 3 weeks for delivery.
Surcharge for Express service with overnight shipping: add $20.
Please inquire about shipping charges outside North America.

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