| Full
Name: | |
| Where
do you live (city & country): | |
| | Email
address: | |
| | Confirm
email address:
- as this is our only way to get in touch with you | |
| Date
of birth (DD/MM/YYYY): | |
| | Client
status: | |
| | Payment
method: | |
| | Should
you use a gift voucher as full or part payment, please quote your gift voucher
code: | |
| Ordered
reading: | |
| For
a reading by phone, please state your phone number, so we can check whether we
can call you. | |
| For
a reading via skype,
please state your skype name: | |
| Please
suggest your preferential
time & date for your reading:
| |
| Readings
are always with the aid of cards, but | | |
|
please choose regarding angel messages: | |
|
please choose regarding astrology : | |
| If
you like Eva to also have a look at astrological charts during the reading,
please
also provide us with the following details, so Eva can draw up the charts before
the reading already: |
| Place
of Birth (town & country): | |
| Time
of Birth: | | |
| If
your question/s involve/s any other person/s, please also state their DOB, time
of birth and place of birth (city & country): | | |
| If
you like Eva to include astrology, please state the topic/area of your question/s: | | |
| | | |
It
would help us to know, where you heard about our services.
If it was through
a search engine, please state which one,
plus the word used in your search.
Many thanks. | | | | |
Would
you like to keep informed about special offers or news
[Your
email will only ever be used for our communication with you, but never sold to
any third party. ]
| | | | |
Should
you have not provided your home phone number yet,
please do so now. Just
in case there is a technical or internet problem
at the time of the reading,
and we need to get in touch. | | | | |
| Any
other information you would like to give us? | | | | |
Many
thanks. After
the receipt of your payment & the receipt of this form,
Eva will be in touch with you by email shortly
to arrange a convenient time for your reading. |
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About
Us