Image Of Shreem - The UniverseImage Of Shreem - The Universe Vedic Astrologer Pandit Parsai
Hindu Vedic Astrology



Horoscope Order Form

When completing the Order Form, please note these points:

Written answer(s) to question(s) asked below
(Brief Horoscope is prepared for this purpose):
$120 (US).

Correct birth time determination: Additional $40 (US) (optional).
 
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Order answer(s) to question(s) asked below*

Amount for answer(s) to question(s)*

Order Time Correction

Amount for Time Correction

Total Amount*



  First Name*  
  Last Name*  
  Address*  
  City*  
  State*  
  Zip*  
  Country*  
  Phone  
  Fax  

 
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  Email*  
  Date of Birth - Day*  
  Date of Birth - Month*  
  Date of Birth - Year*  
  Time of Birth - Hours*  
  Time of Birth - Minutes*  
  Is Time of Birth Day Light Saving Time?*  
  Place of Birth - City & State*  
  Place of Birth - Country*  
  Male / Female*  
 
The following information will help
Astrologer Pandit Parsai to verify the
correctness of the birth information:

 
  Education  
  Profession  
  Marital Status*  
  Number of Children - Son*  
  Number of Children - Daughter*  
  Father Living   Yes
No
  If Dead Date of Death  
  Mother Living   Yes
No
  If Dead Date of Death  
  Number of Siblings  
  Wearing Any Remedy  
 
Please give Significant Events in your
life with approximate date (month/year)
of the occurences of the event.

Give all four events if you
have ordered Time Correction
  (Examples of Significant Events:
I was in a car accident in January of 1989.
I got married on June 11, 1955.
My first child was born on July 14, 1956.
Graduated from College in 1999.)
  Significant Event No 1*  
  Significant Event No 2  
  Significant Event No 3  
  Significant Event No 4  
 
State briefly questions you would like
Astrologer Pandit Parsai to answer:
 
(Examples of question:
When will I get married?
Will the current relationship lead to marriage?
When will I get a raise in my profession?
Will we buy a new house this year?)
  Question No 1*  
  Question No 2*  
  Question No 3  
  Question No 4  
  Question No 5  
  Credit Card Type*  
  Credit Card Number*  
  Card Verification Number:*  
  (On the back of your card, locate the final 3 digit number)   Click for help finding Card Verification Number
  Credit Card Expiration Date*  
  Credit Card Expiration Year*  
  Name as it appears on Credit Card*  
  Address to which Credit Card Statements are
sent (Include City, State and Zip)*
 
  By Checking Yes, I here by authorize
Innovision International Inc to charge
my Credit Card the Total Amount above
(and shipping charges if applicable).*
 

 

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charged an additional $10 for shipping by Registered Mail.
 
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in case we need it for shipping purposes.





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