Laurence Hillman - Reading as Gift Order

Order a Reading As a Gift

*Recipient Information*	(please fill in all that you know)
First Name
Last Name
Telephone Home
Telephone Work
E-mail
Address
City
State/Province
Zip/Postal Code
Country
Date of Birth
Place and State (or Province) of Birth
Local Time of Birth, including AM or PM
Source of Birth Time Information
Comments Please mention if this is a surprise or if you would like me to call to make the appointment

*Your Information*
First Name
Last Name
Telephone Home
Telephone Work
E-mail
Address
City
State/Province
Zip/Postal Code
Country
Referred By?

Payment Method

Credit Card Number
Expiration Date
V-Code (3 last digits on the back of the card)
Credit Card Billing Address
Credit Card Billing Zip Code

Your card will be charged $200.00 within a few days of the reading. NOTE: Price after June 1, 2012 will be $250.

This is a secure site, however you can also send a check or money order to:

Laurence Hillman, 679 South McKnight Road, St. Louis, MO 63124, USA.