Class Registration and Payment

Class

Chart Reading date, if applicable

If paying for a chart reading, please include your scheduled date

mm/dd/yyyy

First Name

Last Name

Referred by, or how you found us

Payment

Please provide credit card information. If registering to attend the first night of Foundations of Astrology for free, your card will not be charged unless you decide to join the 8-week class.

Credit Card Number

We do not currently accept American Express

Exp. Date

Security Code

Name as it Appears on Card

Billing Address (including Zip Code, please)

Contact Information

Please note that we do not use or sell this information. It is required only so we have a way to contact you, if needed, about the class or reading.

Phone Number

Email Address

Birth Information

Required for Astrology Classes and Readings

Birth Day

mm/dd/yyyy

Birth Place

Birth Time

Please indicate if time is exact or estimated

Agreements:

By clicking here you acknowledge that you are making a binding commitment to a space in the class or reading and that you understand that your card will be charged after the first class or just prior to your reading date.

I am aware that my payment is non-refundable, though it may under certain circumstances be transferable to another Awareness Institute class or workshop.

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