Hilarion Reading Application

Telephone Reading - Audio CD included - $125.00 (long distance fees are paid by the client to their phone company)

In-Person Reading in Nevada City - $125.00 (Audio CD included)

Remote Reading - Client questions required - $150.00 (Audio CD included)

Additional Typed Transcript of Reading - $85.00

Tell us what you want:

[ ]Audio CD of Telephone Reading

[ ]Audio CD of Remote Reading (My questions are attached)

[ ]Typed Transcript of Reading

[ ]Please call me to schedule in-person reading

I understand that any health-related information that may be given in this reading is offered for its suggestive and informative value, and is not to be relied upon as a medical authority. I agree to accept full responsibility for the practical application of the information provided, and to relieve Jon C. Fox, all participating conductors, staff and consultants, and their successors and assigns, from any such responsibility.

Signature________________________________________ Today's Date ________________

Name ___________________________________________ Sex_____

Day Phone_______________________________ Evening Phone_______________________

Address_______________________________________ E-Mail_______________________

City___________________________State, Province or District ________________________

Zip Code/Postal Code ____________Country ________

In a telephone or remote reading, Hilarion will tune into you. Please tell us the following so they can do this accurately:

Name at Birth ________________________________________

Date of Birth: Month _____________ Day ________________ Year ___________

Time of Birth________________ Place of Birth _________________________________

Thank you! ......Total Amount: $______________

NOTICE: The billing for these items will appear on your credit card statement as "The Hilarion Co."
If you have any questions, you may contact us at 530-478-1002.
If you prefer, you can FAX us this form: 530-265-0720 (24 hours a day, 7 days a week).

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