Nancy Powell Psychic Reader

Please print and complete the form below.

Name:___________________________________

Birthdate: Month_________________Day_______Year__________

Address:_______________________________________

City:___________________, State:_______ Zip Code:________________

Tarot Readings:                     Qty.                     Price Each                       Total

 2 Card Reading _____         ______                  $2.00                           $__________

3 Card Reading _____          ______                  $3.00                           $__________

4 Card Reading _____         _______                 $4.00                           $__________

5 Card Reading _____         ________               $5.00                           $__________

Rune Stone Readings:        Qty.                      Price Each                        Total

2 Stones _____              ______                   $2.00                            $_________

3 Stones _____             _______                  $3.00                            $_________

4 Stones _____             _______                  $4.00                            $_________

Life Path Readings                                        $2.00

*Prayer Requests             ________               $1.00                              $___________

(*To submit a prayer request, please give the person's name and a brief description for type of prayer)

                                                                                              Subtotal    $______________

                                                                                             Processing Fee  $1.00

                                                                                             Total        $_____________

Due to large volume of mail recieved please allow 2-3 weeks for reply.

Please send check or money order in a self addressed stamped envelope to:

Nancy Powell

P.O. Box 1342

Memphis, TN 38101

*PLEASE DO NOT SEND CASH. Checks and money orders should be made out to Nancy Powell.