                 ===================================
                   PALMS READER REGISTRATION FORM
                 ===================================

        YES, I'd like to receive registered Palms Reader!


       NAME:_____________________________________________________

    ADDRESS:_____________________________________________________

            _____________________________________________________

       CITY:________________________ STATE/PROV:_________________

   ZIP CODE:____________________ PHONE/FAX:______________________

                                   COUNTRY:______________________


                      Cost US $20.00 per copy

        Shipping and handling included if mailed in North America.
         ( for overseas orders, please, add US $5.00 per copy )


              I ORDER:  _____ copies @ $20.00 : _______

                              >> TOTAL PAYMENT: _______



   Make your Cheque ( ) or Money Order ( ) payable to:



             Yasenow Services Ltd.
             P.O. Box 4704
             Vancouver, B.C. V6B 4A4
             CANADA

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