Astrology Data Request
Please note: This form should accompany a purchased chart. 

In order to create your chart, we need some information. 

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Email *
When is your Birthday?  *
MM
/
DD
/
YYYY
What is the exact time of your birth? You might be able to find this on your birth certificate. If you don't have it, just put 12:00 noon. *
Time
:
Where were you born (example: New York City, New York, United States)?  *
If purchasing a chart that requires an additional chart (i.e. A compatibility or synastry chart) please put the additional information (Time, date, and place of birth) below. 

You can also choose a time, date, and place of an event. 

If you are purchasing a chart for only you, you can skip this question.

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