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PRIVATE READING CONTACT INFORMATION FORM IMPORTANT: This form does not work with Autofill or any other automatic form completion softwares. Please do not let your computer automatically fill in any information for you. Thank you!

Please Select One:



Mailing Address

Billing Address (if different):

How Did You Hear About Nancy?

Daytime Telephone:

Night Time Telephone:

Email Address:

Skype Name (if available)

Preferred Method of Contact for Reading


Type of Reading Requested:

Preferred Date for Your Reading (if Possible):

Preferred Time for Your Reading (if possible):

Yes, I Have Made My Online Payment for:

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