Use our Order Form with Your Credit Card, Check, or Money Order.

Credit Card Order for US and International Customers

Get PDF OR Word Order Form.

Download the Order Form PDF file here.
For Microsoft Word Version, E-mail us. In the “Subject Line”, please type “Please Send Credit Card Order Form”. When we receive your e-mail, we will send you a Microsoft Word Version of the order form.

Complete this form.
Submit your order form –

Please call in your credit card information to us at 602-569-1050
Fax the form to us at 602-569-9640
E-mail the Word version to us at E-mail OR
Mail to Hollandcodes.com at –
Holland Codes Resource Center
4133 E. Siesta Lane
Phoenix, AZ 85050

We will process the order.
For printed and CD-ROM materials, you will receive a Notification of Payment e-mail from us that lists the product costs, shipping costs, and package tracking information.
For on-line assessments, you will receive a Notification of Payment e-mail from us that lists the product costs, assessment web page link, user name, and password.
For downloads, you will receive a Notification of Payment e-mail from us that lists the product costs, download web page link, and download instructions.

Check or Money Order For US Customers Only

Here are the simple steps to order using a check or money order -

Download the Order Form PDF file here OR request an order form below.
Complete the Order Form.
Make out your check to the Holland Codes Resource Center
Mail the Order Form and check to:
Holland Codes Resource Center
4133 E. Siesta Lane
Phoenix, AZ 85050 USA

We will ship the product as soon as we receive your check.

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
Special Product Order Form
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-Mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Country*
Home Phone*
Product Name and Quantity*
Special Shipping Instructions: Fedex Overnight*
Please enter the word that you see below.

Special Product Order Form

Do you have any questions?

E-mail or call us at (602) 569-1050.

Do you want a product that is not on the Order Form?

Submit a request for a Special Product Order Form.

Complete the form above.

Get motivated and inspired! Text/ call us at (602) 753-9112 (12pm to 5pm GMT-07:00) or moreinfo@hollandcodes.com. 4133 E. Siesta Ln. Phoenix, AZ 85050, Copyright © 2004-2017 Dr. Mary Askew. All Rights Reserved.