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Yagya Performance Request
  1. Instructions:- Please fill up the form completely and correctly. Be to the point. Write only important problems. This form is to request an astrological service directly and for those people who either have made payment or are ready to make online payment now. If you mean to have advise which Yagya you should choose, then kindly request a YAGYA RECOMMENDATION REQUEST from the menu. QUESTIONS ? CALL +1 646 480 9003 | +44 20 8133 5343 OR COME ON LIVE CHAT
  2. First & Middles Name (full, as on passport)*
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  3. Last Name / Family Name
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  4. Sex
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  5. Marital Status
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  6. Exact Profession
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  7. Nationality
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  8. Birth Date (ex. 23 jan 1965)
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  9. Birth Time (ex. 23.45.30)
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  10. Birth Place
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  11. USA States
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  12. Other Sates (Non-US)
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  13. Birth Country
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  14. Street Address
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  15. Village or City
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  16. Postcode / Zip*
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  17. Country
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  18. Email*
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  19. Telephone Res. (ex. +1.000.000.0000)
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  20. Telephone Office
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  21. Mobile*
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  22. Fax*
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  23. I am
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  24. My Previous Yagya (by whom, when, what ?)
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  25. Yagya No. (Yagya Reference / booking No. Starts with #201)*
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  26. How would you pay? (press Ctrl key to select multiple options)*
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  27. Have you made the payment ?
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  28. Payment ID
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  29. Yagya Codes (Yagya codes are like VY110A)*
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  31. Upload your recent photograph (not mandatory, well accepted)
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  32. I need urgent processing,
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  33. Where did you about know us ?*
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  34. Memnership No.(If any. It is your first Yagya No.)
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  35. Best contact method
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  36. Time G.M. T. (ex. 23.50)*
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  38. Have you made the payment?
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  39. Payment details
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  40. Proposed date for Yagya (ex. 23 Oct 2013)*
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  41. Method of work*
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  42. Promotion Code (if any)*
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  43. Newsmail Subscription
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  44. Input Declaration
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  45. Terms and Conditions
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  46. Declaration Awareness*
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  47. Indemnity Disclaimer
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  48. Verify you are not spammer*
    Verify you are not spammer
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  49. As an electronic signature please type your complete name.*
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  50. Thank you for your Yagya Performance Request. Your request shall only be honored and implemented when you have already paid for Yagya or you pay it with-in next 24 hours.

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