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

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.

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 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.

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.

Do you have any questions?

E-mail us.

Submit your request for a Special Product Order Form above.

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