dpw Designs Software Registration Form
  --------------------------------------

  Please print this form, fill out the following items, and send it
  with a check or money order (U.S. funds only) to:

        dpw Designs
        Software Registration
        P.O. Box 192
        Norco, CA  91760-0192  USA

    Name _________________________________________________

    Address ______________________________________________

    City _______________________  State ____  ZIP ________

    E-mail ____________________________________ [required]

    HotSync User ID ___________________________ [required]

      [ NOTE:                                            ]
      [  Your HotSync User ID can be found on the main   ]
      [  screen of your Pilot/PalmPilot/WorkPad HotSync  ]
      [  application, following the text "Welcome".  On  ]
      [  the Palm_III it is located in the upper right   ]
      [  corner of the screen.                           ]


    Product                      Qty      Price
    ----------------             ----     -----
    Convert-It!                  [  ]  x  $5.00  =  $________

    Optional Postal Delivery (3.5" Disk)  $4.00  =  $________

                                            Total:  $________

    Thank you for registering Convert-It!

    Upon receipt of your order, you will be sent an e-mail message (or
    optional postal delivery) containing the current version of the
    requested software and a key to turn off the registration reminder.

  We would appreciate your comments:

    How did you hear about us? ________________________________________

    ___________________________________________________________________

    What other products would you like to see from us? ________________

    ___________________________________________________________________

    Additional comments: ______________________________________________