Cal-IPGCA COHORT 2019 REGISTRATION FORM:  July 10

Seeking Leaders - Innovators and Change Agents...Are we talking about YOU?

Registration is closed! Please, sign-up for the Cal-IPGCA Association to join the innovation movement!

California Innovation Playbook for Government Change Agents, Cal-IPGCA, is structured as a 360º applied training environment. Trainees toggle between monthly classroom training and applied experiential learning within their work environment. Integrating and synergizing participation across all levels of government – from entry level to senior executives, innovation teams come together to develop specifically targeted moonshot projects to meet key enterprise-wide challenges identified by the State of California agency leaders.

Cal-IPGCA Executive Sponsors: Government Operations Agency, Department of General Services, Franchise Tax Board, ORA Systems, Inc., and the Asian Pacific State Employees Association

Who should attend?

Cal-IPGCA is designed for Government Employees and Technology-based Academia, Private Enterprise, and NGOs representing:

Line staff who are rising stars with management potential;
First line supervisors;
Middle managers, executives, and executive leadership; and
Technology-based academia, data analysts, coders and app developers.

Professional Development Hours (PDHs) and Cost

Meets the State of California’s biennial leadership training requirements. (GC 19995.4.)
Full-time: 62 PDHs ($2850)
Part-time: 38 PDHs ($ 495)

How to apply:

Review the program brochure before applying. The responses in the application determine the innovation team trainees are assigned to in Cohort 2019.
A maximum of 72 Full-time trainees will be admitted and up to 35 Part-Time. (19 Departments participated in 2018)
Some departments require Senior Management Approval. Other departments the approval of the employee supervisor.
Trainees will not be admitted without supervisor approval. This approval is a component of the application.
Complete the application and submit.
Applicants will be reviewed and approved within two weeks of submission with registration continuing until registration is full.
Registration will close June

1.Applicant Information(Required.)

Agency/Dept/Entity Name:

Applicant's First Name:

Applicant's Last Name:

Applicant's Title:

Applicant's Business Mailing Address:

City:

State:

Zip Code:

Email Address:

Work Phone Number:

Cell Phone Number:

2.How many years have you been employed by the State of California, if applicable?(Required.)

3.I am submitting this application to be considered for the following opportunities:(Required.)

As a full-time trainee: (62 Professional Development Hours @ $2850 Per Trainee.)

As a part-time, work-based trainee. (38 Professional Development Hours @ $495 per trainee.)

As a Facilitation Assistant; e.g., one of 6 training positions under Cal-IPGCA 2019, at the rate of $2850 per trainee.

As a Cal-IPGCA "Masters Program" Candidate (62 Professional Development Hours @ $2850 Per Trainee.) Note: ONLY trainees that have graduated from a former Cal-IPGCA Cohort can apply for this category. This is a pilot program initiating with Cohort 2019.

As an one of six University Scholarship Interns. (This is a fee-paid sponsored scholarship - Current Student ID Card required.)

As a private-sector entrepreneurial partner (62 Professional Development Hours @ $2850 Per Trainee.)

4.Please indicate if you are an active member of the following State of California Organizations, or if you are a Community College or University Intern. (Check all that apply.)(Required.)

Cal-IPGCA Association Member?

NxtGov Member?

Asian Pacific State Employees Association (APSEA Member)?

University or Community College Intern?

None of the above.

5.Applicant's Direct Supervisor/Manager: (Note: The applicant's direct supervisor/manager will have an "audit only" seat to review the trainee's progress. The supervisor MUST approve the applicant's registration.)(Required.)

Agency/Dept/Entity Name:

Supervisor/Manager First Name:

Supervisor/Manager Last Name:

Supervisor's/Manager's Title:

Business Mailing Address:

City:

State:

Zip Code:

Email Address:

Phone Number:

6.Status of Supervisor's/Manager's Awareness of this Submission:

Note: Applications cannot be approved without supervisor approval. (If you are applying as a University Intern under a scholarship, the course fee is sponsored. A valid school ID is required.)(Required.)

Yes

Does not apply.

My supervisor/manager recommended and/or approved the submission of this application.

Yes

Does not apply.

My supervisor understands that this is fee based training and has agreed the training fee has been allocated for my attendance.

Yes

Does not apply.

Does not apply

Yes

Does not apply.

7.If you are applying as a University Intern, please upload your current Student ID here. Your application is not VALID without receipt of a current school ID.

No file chosen

11.If applying as a full-time trainee, are you electing to include the USC 360-degree professional development assessment + two-45 minute Executive Coaching Sessions?

Note: This represents an "add-on" fee of $550. This is a significantly discounted rate offered to Cal-IPGCA full-time trainees by USC.(Required.)

Yes, please add the USC 360 Professional Development Assessment and Executive Coaching Package to my curriculum. (Your department will be invoiced for this service in conjunction with your training package.)

No, do not choose to elect this package.

12.Explain why you want to be considered as a Cal-IPGCA Leader, Innovator and Change Agent trainee, (or Assistant Facilitator) for the 2019 Cohort. Your response is important as it indicates your motivation to be considered for acceptance. (Required.)

13.Should you have questions or comments, please identify in the space provided below.

1 / 1

100%

Cal-IPGCA COHORT 2019 REGISTRATION FORM: July 10 - November 12, 2019

Seeking Leaders - Innovators and Change Agents...Are we talking about YOU?