Personal Birth Chart Readings by Derek Hawkins Application form for a postal reading. (If you would like an appointment to see Derek call 01488 681355) £75 in support of The Sam Buxton Sunflower Healing Trust
Pay on line here. Copy and paste this form into outlook express or print and post if you are paying by cheque
BIRTH DETAILS Name Date Place Time* *If you are not sure of the time, please give any ideas you have along with a photograph to assist dowsing.
Your Return address details: Name Address Email Tel. Please make cheques payable to Derek Hawkins and send with completed form to him at : 11 Meadow View Hungerford Berkshire RG17 0YY Payment should be in £ Sterling.

Personal Birth Chart Readings by Derek Hawkins

Application form for a postal reading.
(If you would like an appointment to see Derek call 01488 681355) £75
in support of The Sam Buxton Sunflower Healing Trust

Place Time*

*If you are not sure of the time, please give any ideas you have along with a photograph to assist dowsing.

Your Return address details:

Name

Address

Tel.

Please make cheques payable to Derek Hawkins and send with completed form to him at :

11 Meadow View Hungerford Berkshire RG17 0YY Payment should be in £ Sterling.