Coniunctio Astro Notes Sign-Up Form

REGISTRATION FOR "ASTRO-NOTES"

ROCKETS' OCCASIONAL ASTROLOGY UPDATES

Yes! I would like to receive Astro Notes from Rockets and Coniunctio at my e-mail address listed below.

My Personal Information:

My Name:
My E-mail Address:
Do you have some familiarity with astrology?	Yes: No:
Have you had your chart read by an astrologer?	Yes: No:

If you are willing to share your birth data, please enter it here:

Your Birth Event:	Birthday: Birth Month: Birth Year:
Birth City:
Birth State/Province:
Birth Country (If outside of U.S.):
Your Birth Time:	Birth Hour/ Birth Minute: AM: PM:

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