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Astrology Consultation Paid For!

You have succeeded in paying for astrology consultation with me, Dusko Savic. Now please fill in the following form. Be sure that your email address is correct, otherwise we won't be able to communicate!

Astrology Consultation
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-mail Address*
Street Address
Zip/Postal Code
Home Phone
My main problem is:*
Date of birth*
Month of birth*
Year of birth*
Hour of birth*
Minut of birth*
How certain are you that the hour and minute of birth are accurate?*
Place and country of birth*
When did you first start noticing the problem?
Any other comment?

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