To Order Your Natal A5 Spectrum

Print out this page on your printer and write in the information. The birthdata is used to set up your birthchart. Include a check for $10.00 (MN residents, $10.74) to "BPI" to cover costs (please use US funds). Mail to the address at the bottom of this page. Allow 4 weeks for deliver.

All information you provide us is strictly confidential. The email address or phone number is in case there's a mix-up in communications that we need to clear up -- retrograde Mercury does happen sometimes!

Name:

Address:

City:

State/Country:

ZIP/Postal Code:

Email address and/or phone number (optional):

Birthdata:

Date of birth (month, day, year):

Time of birth (time, AM/PM, timezone):

City of birth (city, state/country):