Online Birth Data form

Use this form to prepare your online order of a custom Astrological Art Chartwheel, a personalized astrology report, or a custom birth chart interpretation reading. When you have filled out all the fields, click on the Generate button to generate the custom Add to Cart buttons.

Personal Birth Data:

Name (as you would like it to show on the chart) of the person whose chart is being ordered:

Gender:

Date of birth:

Day: Month: Year:

Time of birth:

Hour: Minute: AM or PM:

(Selecting "unknown" will result in an inaccurate chart. Use it only if there is no way to find out the time of birth, e.g. if there is no birth certificate. In that case, the time will be set to noon so as to average the variations that are possible during the 24 hours of the date. The positions of the quick-moving planets, Moon, and Ascendant will be the most inaccurate.)

Place of birth:

City or town:

Province or state:

Country:

OR exact latitude and longitude:

Latitude:

Longitude:

Special Offers:

Special Offer code:

Aside from saving you money on your order, entering a Special Offer code automatically signs you up for the Astrology newsletter if you are not already signed up. You may unsubscribe from it at any time after receiving the Special Offer order you'll be placing today.

Please enter the email address you wish to use for the Special Offer and the Astrology newsletter. (Must be a valid address, otherwise you will not be able to receive anything!):

Email address:

Online Birth Data form

Personal Birth Data:

Date of birth:

Time of birth:

Place of birth:

Special Offers:

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