Online Courses Registration

Thank you for your interest in the Executive Certificate in Home Modification program. You will receive an Invoice within 72 hours of completing this Registration Form.

Cancellation Policy: Once paid, refunds are only provided if student notifies the Program Office at homemods@usc.edu 48-hours in advance of the course start date, or due to extenuating circumstances.

Salutation

*First Name:

Middle Initial(s): 

*Last Name:   

Title

Organization

*Address:

*City:    

*State/Province/Region:

*Postal/ZIP Code:  

*Country:   

*Daytime Phone:

*Evening Phone:

*Fax:

*Email:       

Mr.   Mrs.   Ms.   Dr.

   

EXECUTIVE CERTIFICATE PROGRAMS ONLY

COURSE 1: November 4 - November 21, 2014

COURSE 2: December 2 - December 19, 2014

COURSE 3: January 6 - January 23, 2015

COURSE 4: February 3 - February 20, 2015

COURSE 5: February 24 - March 3, 2015

Final: March 4 - November 11, 2015

How did you find out about us?

By web site, www.homemods.org

By other web site:

By professional organization:

By word of mouth

By advertisement:

By other means:

 

A project of the National Resource Center on Supportive Housing and Home Modification,
in affiliation with the Fall Prevention Center of Excellence, funded by the Archstone Foundation.
Located at the University of Southern California Andrus Gerontology Center, Los Angeles, California 90089-0191 (213) 740-1364.