Geomancy.Net – Newborn Baby Chinese Name Consultation Form v2.0
Please provide the following required information. Fax to (65) 6482-0570 or e-mail to support@geomancy.net. NOTE: This service is only for Chinese Names Only. It is not possible to analyse non-Chinese Names based on this name analysis system.
Total Pages (if fax):
__________
Contact Person: __________________________________________ Contact Number: _________________ (HP) _________________ (Tel) E-mail Address: __________________________________________ Urgency of Work: [ ] Normal within 3-5 days [ ] Urgent within 48 hours (Extra service fee will be chargeable if not paid during order) Comments: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Page 1/3
Full Name Baby’s Detail (REQUIRED) 1. ______________ Chinese Surname ______________________________ English Name Baby’s Father (REQUIRED) 2. ______________________________ Chinese Name
Gender Date of Birth [ [ ]M ]F Hour of Birth: ____________ _______ / _______ / ______ (day) (month) (year)
Calendar [ ] English / Gregorian / Western ] Chinese Lunar
[ If unknown, please fill N/A. Male _______ / _______ / ______ (day) (month) (year) Hour of Birth: ____________ [ [
] English / Gregorian ] Chinese Lunar
______________________________ English Name Baby’s Mother (REQUIRED) 3. ______________________________ Chinese Name Female
_______ / _______ / ______ (day) (month) (year) Hour of Birth: ____________
[ [
] English / Gregorian ] Chinese Lunar
______________________________ English Name Baby’s Siblings (REQUIRED) 4. ______________________________ Chinese Name ______________________________ English Name 5. ______________________________ Chinese Name ______________________________ English Name 6. ______________________________ Chinese Name ______________________________ English Name 7. ______________________________ Chinese Name ______________________________ English Name [ [ ]M ]F [ [ ]M ]F [ [ ]M ]F [ [ ]M ]F
_______ / _______ / ______ (day) (month) (year) Hour of Birth: ____________ _______ / _______ / ______ (day) (month) (year) Hour of Birth: ____________ _______ / _______ / ______ (day) (month) (year) Hour of Birth: ____________ _______ / _______ / ______ (day) (month) (year) Hour of Birth: ____________
[ [ [ [ [ [ [ [
] English / Gregorian ] Chinese Lunar ] English / Gregorian ] Chinese Lunar ] English / Gregorian ] Chinese Lunar ] English / Gregorian ] Chinese Lunar
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Additional Information
Any Existing or _________________________________________________________ Preferred Names to check name stroke: _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Need to follow Family _________________________________________________________ Book (Zhu Pu)? (If yes, list character) _________________________________________________________ _________________________________________________________ If not 1st Child, keep [ common name? [ [ [ ] Not applicable (for 1st child) ] Keep Middle character name from sibling ] Keep Last character name from sibling ] No need to keep common name, allow flexibility to find entirely different Middle and Last character name.
When do you need to _________________________________________________________ register your baby name? _________________________________________________________
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