Energy CatalystOrder Form

For each desired report, fill out this form selecting the report you would like to purchase. Print the form(s) and mail or fax to:
Energy Catalyst
2201 Brookhaven Ct
Fallston, Md   21047
 Phone: 410-877-9616
ellenpotter@bigfoot.com

(If paying by check, make checks payable to Energy Catalyst; if paying by credit card, please fill in card info. at bottom of form.)

Friends & Lovers Compatibility Report  $9.95  
Heaven Knows What  $9.95  
Simpáticos  $9.95  
TimeLine Forecast Report  $4.95  
Woman to Woman Report  $14.95  

For all reports (except Friends & Lovers and Simpaticos) fill out just the birth data for "Person #1". For F&L and Simpaticos, fill out the both "Person #1" and "Person #2" (for the two individuals involved).
[If ordering Friends & Lovers, select: Friends or: Lovers ]

Birth Chart Information
Person #1
[Needed for all reports]
Name: (Last name, First)

Gender: Male Female
BirthDate:

Please enter actual time
per birth certificate:

BirthTime:
(most accurate report)
:
OR, if you don't know
your birthtime, Check here:

Birth City:
Birth State: (or Country)

Person #2
[Needed for all reports]
Name: (Last name, First)

Gender: Male Female
BirthDate:

Please enter actual time
per birth certificate:

BirthTime:
(most accurate report)
:
OR, if you don't know
your birthtime, Check here:

Birth City:
Birth State: (or Country)

Your Mailing/Contact Information:
First Name: Last Name:
Street: City:
State:
(or Country) 		Zip Code:
Credit card #: Expires:
C. Card Name: Email Address:


Please send the report by Email   Mail


[Note: AOL and WEBTV accounts do not permit emailing these reports (do to their size limitations).]