Request of Psychegraph (Letter of Die):
Complete they data below and send for mail:
Date:
;
Name full of Die:
;
Cause of Death:
;
Sex (him or her):
;
How long do that Die (**year):
;
How many year have whem Die
(**year):
;
Name full of who ask:
;
Name Street:
;
Number of home:
;
District:
;
City:
;
State:
;
Country:
;
Mail Code:
;
E-Mail:
@
;
Attention:
-Send its psychegraph ( Letter of die ) request
by mail with the filled data and with $4.00 (four dollars of expense Mail)
for the return of its letter.
-Send its request for:
Center Espirit Commandant
Alexandre Motta - Travessa Luís Barbalho, 61
Vila Assunção
-Santo André -São Paulo - Brazil
CEP: 09181-560
Obs:
Make its request as requested
him above, otherwise it will be canceled automatically.
Information for the E-Mail:
frossard@cebinet.com.br
Tel: 051-011-4499283