Tim Brooks - Tarot Reader, Secure, Online Booking Form

{Tim Brooks, Tarot Card Reader, Logo}

Please fill in as many fields as possible (note - use your mouse to move between fields, not the tab key) and press submit button once. If you do not get an acknowledgement from me within 48 hours then please e-mail me. Thank you.



First Name
Last Name
Email Address
Address - Line 1
Address - Line 2
City
State or Province
Zip or Postal Code
Country

How did you hear about Tim Brooks?

Please select search engine (if applicable)

Information which you wish to provide
Area you want Tim to concentrate on (or specific questions)
Payment Details. Note that Cheques must be from a UK bank
Card Type
Name of Issuing Bank
Card Number
Card Expiry Date
Name & Initials (as they appear on the card
Security code (usually 3 or 4 digits on signature strip)

Which Service do you want?

 


Post your cheque and/or written request to: Tim Brooks, 82 Brook Gardens, Emsworth, Hampshire, PO10 711, UK

Please e-mail timbrooks@apricotsunset.com with your details if you are unable to make the secure form work

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