SNAKE & SNAKE PRODUCTIONS Telephone Orders: 9am-9pm E.S.T. 3037 Dixon Rd. 919-401-9591 Durham, NC 27707 Name:__________________________________ Minimum $10 VISA MasterCard Street:________________________________ Card #__________________________ City:__________________________________ Exp. Date___________ State:_________________ Zip:___________ Signature: _____________________ Country:_______________ Phone: ( )______________________ Natal Astrology Report Birth Data: Name:________________________________ Birth Time: ________ ___ ___ ____ Location: __________ _____ _______ Hour:Min Month Day Year City State Country Natal Astrology Report Birth Data: Name:________________________________ Birth Time: ________ ___ ___ ____ Location: __________ _____ _______ Hour:Min Month Day Year City State Country Compatibility Report Birth Data: First Person: Birth Time: ________ ___ ___ ____ Location: __________ _____ _______ Hour:Min Month Day Year City State Country Second Person: Birth Time: ________ ___ ___ ____ Location: __________ _____ _______ Hour:Min Month Day Year City State Country Please pay by check, money order, or credit card in US funds. Quantity Cost Total Natal Astrology Chart ________ $15.95 _____ Compatibility Report ________ $15.95 _____ Sales Tax (only in North Carolina) x 7.75% _____ Shipping _____ Grand Total _____ SHIPPING & HANDLING Everywhere Quantity USA Delivery Canada & Mexico Else One Chart $5.00 6.00 7.00 Each additional +0.50 +1.00 +1.50