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Questionnaire/Order Form

Order Form and Questionnaire

Your Name:___________________________

E-mail Address: _________________________

Birthdate: ____________Place of Birth:________________Time (if known)_________

Mailing Address:_____________________________________City:______________State:_____ Zip Code:________

Name of Person Significant to Reading (if applicable):_________________________

Birthdate: ____________Place of Birth:________________Time (if known)_________ ************************************************************************************** Tell me something about yourself and your situation: ________________________________________________________________________________________________________________________________________________________________________________________________________________________ (if you need more space--write me a separate note)

Your Five Specific Questions: 1.





************************************************************************************** Price List/Readings Offered

Remember: With initial order of a Full Tarot reading--a free astrological chart, and a complimentary reading with the Goddess Oracle is included! ***** My regular clients receive Full Tarot readings for $30 with complimentary Goddess Oracle reading included Order

**Full Tarot Reading with Tarot of the Orisha: $35 ($30 repeat clients) _____

**Full Tarot Reading with traditional Tarot deck: $35 ($30 repeat clients) _____

**GIFT SPECIALS for Birthdays, Holidays, etc...** Purchase one gift reading for $35 and your reading is $20. Total cost is $55 _____

**Mini Tarot Reading: $20 (Does not include astro chart or Goddess Oracle) _____

**Crystal Pendulum with Channeling (answer 3-5 questions) $15 _____

**Goddess Oracle Reading: $20 _____ Subscription Options

Monthly Subscription--includes 2 Tarot readings Cost: $50--$20 Savings!! _____

6-Month Subscription--same as above: Cost: $250--Savings of $50!! _____

Total Purchase: _____

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