Boys' Particulars

Name          

Date of Birth      Time of Birth
(if time of birth includes daylight saving, please deduct and enter time of birth)

Location Coordinates of Your Birth Place or Nearest Place

Country    State


Girls' Particulars

Name          

Date of Birth      Time of Birth
(if time of birth includes daylight saving, please deduct and enter time of birth)

Location Coordinates of Your Birth Place or Nearest Place

Country    State