Information for your Family Dynamics Report Book (including Natal Only and Relationships Only):

How many adults do you want to include? ____ How many children? _____

Preferred family last name: ______

Adult 1 name: ______Role in family:______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Adult 2 name: ______Role in family:______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Child 1 name: ______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Child 2 name: ______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Child 3 name: ______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

If you wish to add additional family members, please provide the above information about each member, on blank paper or on photocopies of this sheet. To add your family dog, fill out the canine report information form below.

Information for individual chart reports (indicate any gifts for which you are ordering a gift folder & envelope):

For each individual natal report you are ordering, please provide (use more paper if necessary):

Name: ______Adult ___ OR Child _____

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Name: ______Adult ___ OR Child _____

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Name: ______Adult ___ OR Child _____

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

For each relationship report, please provide for each person (use more paper if necessary):

Person 1 Name: ______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Person 1 Name: ______

Birth month/ day/ year: ______Place: ______

Time: ______AM or PM? ______OR: time unknown? (will affect relationship reports)______

Nature of relationship: Romantic ____ Non-romantic ______

For each canine report, please provide (use more paper if necessary):

Dog name: ______Male __ or Female ___

Birth month/ day/ year: ______Place: ______

Time: unknown ______known: ______AM or PM?______

Astro-Insight Reports Order Form

Please enclose a completed information form for each report you are ordering.

Astro-Insight Report Services

/ Order by 10/15 and
pay only / Price after
10/15
(thru 12/15) / How many? / Information
form
enclosed? / Total

FAMILY DYNAMICS report binders

Family Dynamics: 2 adults, 1 child / $ 48.95 / $ 58.95
Natal interpretations only / $ 24.95 / $ 29.95
Relationship interpretations only / $ 24.95 / $ 29.95
Family Dynamics: 2 adults, 2 children / $ 64.95 / $ 84.95
Natal interpretations only / $ 34.95 / $ 39.95
Relationships interpretations only / $ 49.95 / $ 59.95
Family Dynamics: 2 adults, 3 children / $ 94.95 / $124.95
Natal interpretations only / $ 44.95 / $ 54.95
Relationships interpretations only / $ 65.95 / $ 89.95
Family Dynamics: 1 adults, 1 child / $ 24.95 / $ 29.95
Natal interpretations only / $ 20.95 / $ 24.95
Relationships interpretations only / $ 14.95 / $ 19.95
Family Dynamics: 1 adult, 2 children / $ 48.95 / $ 58.95
Natal interpretations only / $ 24.95 / $ 29.95
Relationships interpretations only / $ 24.95 / $ 29.95
Family Dynamics: 1 adult, 3 children / $ 64.95 / $ 84.95
Natal interpretations only / $ 34.95 / $ 39.95
Relationships interpretations only / $ 49.95 / $ 59.95
Add canine report (birth date required) / $ 5.00 / $ 5.00
Other Family Size (call or e-mail first for price)
INDIVIDUAL REPORTS
See for email prices
Child’s natal chart report / $ 10.95 / $ 12.95
Adult natal chart report / $ 12.95 / $ 14.95
Relationship report (romantic) / $ 12.95 / $ 14.95
Relationship report (nonromantic) / $ 12.95 / $ 14.95
Couple’s package: 2 natal + relationship report / $ 34.95 / $ 39.95
Canine report (birth date required) / Time unknown
$ 7.95 /

Time known

$ 9.95
3 month forecast / Time unknown
$ 18.95 /

Time known

$ 24.95
Solar return (birthday year) forecast—need
location where the report recipient will be on the
birthday:______/ $ 18.95 / $ 24.95
Add gift folder & envelope to any report / $ 5.00 /

$ 5.00

/ SUBTOTAL
/ TAX:
NJ orders add
7%
TX orders add
6.25%
Shipping & handling
(see box at left)
TOTAL