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Your Name & Contact
* Please check your email 'Promotions' and 'Spam' folders once you've submitted this form if you don't see replies in your usual inbox.
Name
*
First Name
Last Name
Email
*
Re-Enter Email For Accuracy
*
Remember to watch Promotions & Spam folders for business replies and chart deliveries.
Phone Number
*
Please enter a valid phone number.
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Details To Go On Chart
If this is for a gift, please use the details of the recipient rather than yourself.
Full Name At Birth: (correct spelling)
*
First Name
Middle Names
Last Name
Full Current Name: (correct spelling)
*
First Name
Middle Names
Last Name
Date Of Birth: (correct details) (month, day, year, and time if available)
*
Location Born: (correct location) (city, province, country)
*
Today's Order: (see website for details, FAQ, & current fees)
*
1 Custom Personalized Astrology / Numerology Chart
Subscription of 3 Monthly Charts
Subscription of 6 Monthly Charts
Subscription of 12 Monthly Charts
I'd like to receive some of my subscription charts together at once rather than monthly. (please contact Heather to discuss)
Matching Order Add-Ons: (see website for details & additional fees)
Add-On Mini Report (summarized details) (additional fee)
Add-On Full Report (multi-paged & highly detailed) (additional fee)
Add-On Slideshow Report (breakdown w/ images) (additional fee)
Add-On Video Report (breakdown w/ images) (additional fee)
Add-On Printed Merchandise (mugs, t-shirts, framed prints, etc.) (additional fee --- contact to request estimates)
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Chart Aspects
What would you like included on your chart? See website FAQ for details.
Include On Chart:
Western Astrology (most popular / most recognized in North America)
Vedic / Sidereal Astrology
Chinese Astrology Sign
Native North American Astrology Sign
Mayan Astrology Sign
Aztec Astrology Sign
Celtic Tree, Astrology
Norse Rune, Astrology
Birthstones
Numerology
Birth Flowers
Other (specify special requests below)
Other: (specify request for other type of astrology or birth-related detail)
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Chart Dimensions
Select 1 this page = (per) 1 single chart... if you prefer to skip this page you will automatically receive '8.5 X 11 portrait' (regular-sized computer paper) by default. FOR SUBSCRIPTIONS: please specify how many per.
Dimensions -- Printing: (print yourself / professional printers / digital pdf's)
9 X 12 inch, portrait
9 X 12 inch, landscape
8.5 X 11 inch, portrait (reg. printer paper)
8.5 X 11 inch, landscape
8 X 10 inch, portrait
8 X 10 inch, landscape
4 X 6 inch, portrait
4 X 6 inch, landscape
Other (specify below) ( for custom t-shirts, gifts, social media, etc.)
Print Dimensions, Other:
Specify other print size / other details for printing.
Dimensions -- Devices: (digital wallpaper)
Phone, portrait
Tablet, portrait
Phone, landscape
Tablet, landscape
Laptop, Desktop, Smart TV
Device Brand / Model (if known) (for sizing)
Devices, Additional Details: (if needed):
Subscriptions Only: How many charts per print job / device? ----- For example, if you have ordered a 3-month subscription, perhaps list 2 X phone wallpapers in portrait, and 1 X laptop wallpaper.
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Chart Design
Enjoy making your custom aesthetic selections on this page and the next.
# Of Order Forms I'm Submitting:
I'm ordering one (1) chart. All of my custom selections will be on this form.
I'm placing a subscription order but am just submitting this one (1) form. Please feel free to create each of my custom chart designs based on any of my selections here.
I'll be submitting multiple forms so that each chart in my subscription order can be created with different colours and / or styles. I will only be charged once for my full order regardless of how many forms I submit with it. (Contact Heather if requiring multiple forms.)
I have a photo or some artwork I would like incorporated into the design (not required):
Yes, I will forward Heather a high quality jpg or png.
Favourite Colours: (or skip if wide open)
Black
Pink
Turquoise / Teal
Grey
Salmon / Coral
Blue
White
Orange
Indigo
Brown
Yellow
Purple
Beige
Chartreuse
Fuschia
Red
Green
Rainbow
Colour Strength / Style: (or skip if wide open)
Monochromatic
Muted, Barely-There
Pastels
Jewel Tones
Neons
Metallics (will print off metallic-look; no foil)
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Textures / Patterns: (or skip if wide open)
Floral
Paisley
Foliage
Camo
Textiles / Weaves
Pebbles
Stone / Veining
Animal Print (specify)
Geometric
Abstract
Stripes
Solid Colour, No Texture
Polka Dots
Soft Texture
Other (specify below)
Bold Texture
Ombre / Gradient
Themes / Moods / Worlds: (or skip if wide open)
Zen
New Age
Boho
Country Life
Steampunk
Futuristic
Industrial
Waterworlds
Beach / Island
Classicism
Identity / Cultural (specify below)
Space
Weather (specify below)
Cute / Kawaii
Comic Strip / Block
Baby
Kids
Other (specify below)
Other Theme(s) or Details: (specify)
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Additional Information About Your Order: (provide any further details, requests)
Savings Code fields on next page.
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Current Promotion? Enter Savings Code # 1
Current Promotion? Enter a second Savings Code
Payment: E-transfers, Gift Cards --- Select, then click 'Next' & scroll to 'Submit'
I have already paid and received a receipt.
I'm paying via e-transfer within 24 hours of submitting this form. I will forward a password to Heather and receive a receipt. Work will commence once payment has been verified.
I have a gift card from 'Light-Worker Psychic Readings & Energy Healing' to pay for part or all of my order and will contact Heather to use it. Work will commence once the gift card has been verified. Options for any remaining total will be arranged with Heather and I'll receive a receipt.
I will be paying with PayPal, debit, or credit card on the next page today.
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ONLY for: PayPal, Debit, or Credit Card Select --- otherwise scroll to the submit button
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( X )
Personalized Birth Chart $50
1 Birth Chart, (reg. $60) Tax incl.
$
50.00
CAD
3 Month Personalized Birth Charts Subscription, 1 Payment $120
Delivered 1 per month for 3 months, each chart a unique design. (reg. $150) Tax incl.
$
120.00
CAD
6 Month Personalized Birth Charts Subscription, 1 Payment $265
Delivered 1 per month for 6 months, each chart a unique design. (reg. $295) $Tax incl.
$
265.00
CAD
12 Month Personalized Birth Charts Subscription, 1 Payment $550
Delivered 1 per month for 12 months, each chart a unique design. (reg. $580) Tax incl.
$
550.00
CAD
Mini Report Add-On $25
1 delivered, matches 1 chart. Summarized details. Only WITH PURCHASE of birth chart. Tax incl.
$
25.00
CAD
Full Report Add-On $80
1 delivered, matches 1 chart. Multi-paged, highly detailed. Only WITH PURCHASE of birth chart. (re. $100) Tax incl.
$
80.00
CAD
Slideshow Report Add-On $180
1 delivered, matches 1 chart. Breakdown w/ images. Only WITH PURCHASE of birth chart. (reg. $200) Tax. incl.
$
180.00
CAD
Video Report Add-On $230
1 delivered, matches 1 chart. Breakdown w/ images. Only WITH PURCHASE of birth chart. (reg. $250) Tax incl.
$
230.00
CAD
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