Module 5 [Distance Learning]

If purchasing this course for someone else, please enter the student’s first and last name, along with their email address.

E-mail address

Please enter the birth data of the student who will take the course. To clarify, if you will be taking this course, insert your own data. If you are buying this course for someone else, please fill out this form with their information.

Please note that an accurate time of birth is needed in order for us to make an accurate chart. A difference of an hour can give rise to some differences in the chart, although it should still be accurate enough for you to work with reasonably well. If you do not know your time of birth at all, we can prepare a chart using noon as the birth time, but a number of factors will not be accurate.

This fee is payable only once, when you begin studies with the Faculty.

If needed, please use the ‘More Information’ box to mention any other sources.

Use this space to provide more details, if needed.

Check all that apply.