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CERTIFICATE IN ASTROLOGY
APPLICATION FOR ENROLMENT

Name
Address
Post Code
Country
Phone
Email
Date of Birth
Time of Birth
  AM or PM
Place of Birth
  Enlcosed is payment for
Unit .being $530 AU.
Payment
Thomas Cook Cheque (AU)
Money Order/Cheque (AU)
Phone Universal Astrology
to supply payment details.

Phone:
61 07 55945959

Do not supply any card or account numbers through this electronic application form.

Credit Card details are to be transmitted via phone if not payed through cheques.

Payment by Money Order/Cheque,
made payable to:


Universal Astrology

Please return this application form
with payment to:


Universal Astrology
PO Box 279, Southport QLD Australia
4215

Phone: 61 07 55945959



CERTIFICATE IN ASTROLOGY
APPLICATION FOR ENROLMENT



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