Birth Time Form - Find time of birth

	Male
	Female
	First Name(s)
	Surname
Yes No	Is this you? If you want me to find the time of birth of someone other than yourself you need to ask for his or her full permission to do this.
	E-mail contact details – I will respond to you by e-mail. Please make sure you provide an address that is valid for at least one full month after ordering. I cannot take responsibility for you providing something that is or quickly becomes invalid!
	Address Line 1
	Town / City
	Region / County
	Post Code / Zip
	Country
	Phone number (only used to check details if there is a problem with the information supplied)
	Date of birth (dd/mm/yyyy)
	Place of birth Village, Town and nearest city and country
	Additional info – do you have any ideas about the time of day you were born? For example relatives may remember – we’d just had breakfast, the dawn chorus started just after you were born, it was getting dark etc. Please do ask if you can as this information helps me confirm the accuracy of my reading. If you have no ideas just say so, I can work accurately without this information.
	Please add orders@birthtime.co.uk to your address book to ensure you can receive a reply to your order.