Birth Information (3 Reports Purchased) Purchaser’s Name* Purchaser’s First Name Purchaser’s Last Name Purchaser’s Contact Email*The report will be sent to this address. Purchaser’s Phone Number*Which 3 Reports Would You Like? *Choose YOUR 3 Reports belowReport-1*Select Report-1Life Progression ReportNumerology ReportOpportunity ReportPast Life ReportRelocation ReportSimpatico ReportSolar Return ReportTarot ReportTimeline Forecast ReportSpiritual Path ReportRelationships/Friends and Lovers ReportPersonal Astrology ReportOptimum Child ReportReport-2*Select Report-2Life Progression ReportNumerology ReportOpportunity ReportPast Life ReportRelocation ReportSimpatico ReportSolar Return ReportTarot ReportTimeline Forecast ReportSpiritual Path ReportRelationships/Friends and Lovers ReportPersonal Astrology ReportOptimum Child ReportReport-3*Select Report-3Life Progression ReportNumerology ReportOpportunity ReportPast Life ReportRelocation ReportSimpatico ReportSolar Return ReportTarot ReportTimeline Forecast ReportSpiritual Path ReportRelationships/Friends and Lovers ReportPersonal Astrology ReportOptimum Child ReportRequired Birth InformationCustomer Name* Customer First Name Customer Last Name Customer Contact Email*The report will be sent to this address. Customer Phone Number*Birth Date and TimeFill out your date of birth and your time of birth below.Date*Date12345678910111213141516171819202122232425262728293031Month*MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Don't Know Time of Birth*If you do not know the time of birth, check the box below and we will use the time of sunrise. I Don't Know I Know The Birth Time Birth Time*Input the time you were born in the format hh:mm Example- if you were born at 4:22, input 04:22. Hours : Minutes AM PM AM/PM Birth LocationCity*What city were you born in? U.S. StateSelect the state you were born in.NoneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCountrySelect the Country you were born in.AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweOptional 2nd Person Birth InfoWant to get one of your reports for a 2nd person? Answer the following questions- 1) What report do you want for this person 2) First and Last Name 3) Birth Date 4) Birth Time 5) Birth City and StateOptional 3rd Person Birth InfoWant to get one of your reports for a 2nd person? Answer the following questions- 1) What report do you want for this person 2) First and Last Name 3) Birth Date 4) Birth Time 5) Birth City and StateIf you chose Relocation Report, which EXACT city (One) are you considering relocating to?*Only required if you selected Relocation Report as one of your 3 reports If you chose the Simpatico Report, please input partner's birth information below.*Only required if you chose the Simpatico Report for one of your 3 Reports. Include partner's 1) First and Last Name 2) Birth Date 3) Birth Time 4) Birth City and State If you chose the Tarot Report, what is your question?* Only required if you chose the Tarot Report as one of your 3 Reports. Examples of things to ask questions about: Relationships, Love, Career, Guidance, the Future, Fortune/Money 2nd Person Birth Info or CommentsBirth Information (3 Reports)* Price: NameThis field is for validation purposes and should be left unchanged. CONTACT TODAY FOR PERSONAL CONSULTATION Call Joseph Now! - 480 463 1540
