Astrological Timing Service

First Name   Middle Initial
Last Name
Street Address 
City , State Zip Code
E-mail Address
Phone -- Ext.
Birth Date & Year
Birth Place City , State  
Country (If born outside USA.)
Birth Time am pm
Source of Birth Time (i.e., birth certificate, etc.)

Please provide an explanation of the event you would like to have timed (if elective surgery, indicate type of surgery / if new business start, indicate type of business, etc.).  Give me as much data as you can.  I will contact you if I need further information.
Credit Card Information: MasterCard / Visa
Card #: 
Expiration Date: 

Please print your completed form and submit with check, money order or credit card information to the address or fax number below:

Cindy L. Suess

5422 Hermitage Ave., #101

Valley Village, CA 91607

Fax #:  (267) 295-2690

 

You can reach me with questions at (818) 760-7307 or email me at Cindy@depthastrology.com.  It takes approximately 1 week after receiving your data before I contact you to discuss the timing of your event.