Gift Certificates Order - Circle of Light

I WOULD LIKE TO THANK YOU FOR ALLOWING ME TO BE OF SERVICE TO YOU.

I AM DEEPLY HONORED BY YOUR REQUEST. THANK YOU.

LIGHT AND MANY BLESSINGS TO YOU AND YOURS,

REV. CASSANDRA

I send you love.
Secure Online Credit Card Payments

A Circle of Light Counseling
Merchant since January, 1999.
ALL information given is kept in the strictest of privacy.
Occupation
Your Website URL
Your Date of Birth

mm/dd/yyyy

Date Format: MM slash DD slash YYYY
Your Gender

Male or Female
Your Full Name

As it appears on your birth certificate

First

Middle

Last
How did you hear about Rev. Cassandra?

If through a search engine, please let us know which one. ie. – yahoo,
google, excite, infoseek, etc.

If from a friend or relative, please let us know their name. We want to
acknowledge them.

If from another web site, please let us know which one. We want to
acknowledge them, also.
A portion of the fee you pay goes to charity

I felt it would be nice if you choose where that is portion donated
- Child Abuse
- Domestic Violence
- HIV/AIDS Hospice
- Animal Rescue
- All of the above
- Any of the above
What is Your Desired Outcome in Your Hypnotherapy Session(s)
Why did you choose Rev. Cassandra to assist you on your life’s
path?
The Amount in USD (as per email from MariaSuzonne)*

(Include decimal point. Example: write 225.00 not 22500 Writing 22500 will
be billed as $22,500.00)
Thank you and many blessings to you and yours! You will be receiving an
email invoice immediately. And soon you will receive an email from my
administrator.
IMPORTANT PLEASE READ*

By checking the box and submitting, you are stating “I agree. I have read
and I accept A Circle of Light’s
Terms of Service (TOS)”
- I accept
Total

$0.00
Your Email Address*
Your Phone Number*
Your Address*

Street Address

City

State / Province / Region

ZIP / Postal Code

Country
Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code

Cardholder Name

ALL information given is kept in the strictest of privacy.