Mail List Submission Form

Empower U Enterprises, Inc. through our affiliated web sites is expanding our services to benefit
all our customers and clientele with a new Quarterly Newsletter, periodic emailings and occasional
personal mailings. We are offering a FREE gift of your choice for completing this form as our
"Thank You" for giving us the opportunity to serve your spiritual and metaphysical needs.

Those of you who are familiar with us know that we are dedicated to our spiritual
outreach in helping to bring more joy, personal fulfillment and positivity to all the lives we touch. Those
of you who may be new to us, we are glad to see you here and look forward to working with you
to help you reach your highest potential for the good of the whole.

Join our mail list today and receive your FREE gift from the choices listed below.

All you need to do is complete the form and hit "submit form" below.

Your Full Name:
Your Preferred Email Address:
Your Home Mailing Address:
Choose Your Free Gift	Free Natal Astrology Report Free Numerology Report Free 5 Minute Reading Free Blessed and Reiki Charged Quartz Crystal
To receive your FREE Natal Astrology Report we need your Date of Birth, Place of Birth and Time of Birth:
To Receive your FREE Numerology Report, we need your Birth Name, Name You Now Use, and Date of Birth:
To Receive Your FREE 5 Minute Reading, please let us know which Service You Prefer To Use:	Keen Click 4 Advisor Ether MySpace/Skype Psychic Access
Periodically, we send out email announcements of engagements, new services, etc. Would you like to continue to receive these announcements from us?	Yes No
Periodically, we send out physical mailings which may include free minutes, opportunities to receive free gifts and our quarterly newsletter "Trax Tribune." Would you like to continue to receive these mailings?	Yes No
How Did You Hear About Us?

free forms

Thank you for completing this questionnaire and thank you for joining our mail list. We will respond via return email to confirm your choice of FREE gift.

With many blessings always

Dolphyn

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