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 48-hours in advance of the course start date, or due to extenuating circumstances.


*First Name:

Middle Initial(s): 

*Last Name:   






*Postal/ZIP Code:  


*Daytime Phone:

*Evening Phone:



Mr.   Mrs.   Ms.   Dr.



COURSE 1: July 22 - August 8, 2014

COURSE 2: August 19 - September 5, 2014

COURSE 3: September 16 - October 3, 2014

COURSE 4: October 14 - October 31, 2014

COURSE 5: November 11 - November 18, 2014

COURSE 5: November 11 - November 18, 2014

Final: November 19 - November 26, 2014

How did you find out about us?

By web site,

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.