Cohort 2021 Virtual Registration: January 7, 2021 - June 10, 2021

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

Initiating its 9th year of effective and dynamic innovation (2012-2021), California Innovation Playbook for Government Change Agents (Cal-IPGCA) - Cohort 2020, is an immersive experiential learning environment where trainees re-imagine State of California enterprise-wide challenges from a whole-systems perspective to create tangible innovative solutions. Far more than a training program, Cal-IPGCA creates a testbed for developing and implementing best available practices and innovative solutions.

Synergizing participation across all levels of government, from entry-level to senior executives, trainees work in cross-functional teams to develop moonshot projects. At the culmination of the project, each cohort produces an innovation playbook to improve our state’s essential functions. These playbooks include best practices, lessons learned, and a full breadth of analytics. Previous Cal-IPGCA cohort playbooks are available online at www.cal-ipgca.org. (Individual playbooks are also awarded to each trainee, reflecting personal training journey.)

Who should apply - Who should attend?: Cal-IPGCA’s success is fueled by its multi-generational, diverse, topnotch professional integration. Trainees accepted into the program represent a broad spectrum of organizational levels.

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
Regional and Local Government
Technology-based private sector companies and individuals - leaders, change-agents, data analysts, coders, app developers, etc.
Non-governmental Organizations (NGOs)

How to apply?

Review the program brochure
Curriculum and Cost
More extensive information is available at www.cal-ipgca.org.
The responses in the application determine how trainees are assigned to innovation teams for Cohort 2021.

Registration Deadline:

Registration will close Tuesday, January 5, 2021, at 5:00 PM.

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* 1. Applicant Information

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:

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

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* 3. I am submitting this application to be considered for the following opportunities: (Meets the State of California’s biennial leadership training requirements. (GC 19995.4.)

As a full-time trainee: (86 Professional Development Hours @ $3350 Per Trainee.)

As a full-time trainee: (86 Professional Development Hours @ $3350 Per Trainee; under a scholarship offered through the Cal-IPGCA Association, APSEA, OD4CA or NXTGov, per below.

As a Facilitation Assistant: e.g., 1 of 8 training positions under Cal-IPGCA 2021; (102 Professional Development Hours @ $3350 Per Trainee.)

As a Private-sector Entrepreneurial Partner, Non-governmental Organization (NGO), Academic Institutional Participant: (86 Professional Development Hours @ $3350 Per Trainee.)

Skills Bank Beta-Test Applicants: A department/entity submitting applicants as Skills Bank Beta-Testers for Cohort 2021 must have one registered applicant registered for Cohort 2021. With this requirement met, a department/entity is allowed an open-ended number of Skills Bank Beta Testers at $100 per Beta Tester. Minimum SACNetwork Skills Bank Participant for Activation: 7500 participants minimum - Maximum participants: 200,000.

Note: Skills Bank Beta Testers are registered under a separate application.

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* 4. Please indicate if you are an active member of the following California organizations. (Check all that apply.)

Cal-IPGCA Association Member?

NxtGov Member?

Asian Pacific State Employees Association (APSEA) Member?

OD4CA

None of the above.

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* 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.)

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:

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

Note: If a government registrant, applications cannot be approved without supervisor approval.

	Yes	No	Does not apply.
My supervisor/manager recommended and/or approved the submission of this application.	My supervisor/manager recommended and/or approved the submission of this application. Yes	My supervisor/manager recommended and/or approved the submission of this application. No	My supervisor/manager recommended and/or approved the submission of this application. Does not apply.
My supervisor understands that this is fee based training and has agreed the training fee has been allocated for my attendance.	My supervisor understands that this is fee based training and has agreed the training fee has been allocated for my attendance. Yes	My supervisor understands that this is fee based training and has agreed the training fee has been allocated for my attendance. No	My supervisor understands that this is fee based training and has agreed the training fee has been allocated for my attendance. Does not apply.

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* 7. The scheduled virtual training dates for Cal-IPGCA 2021 are listed below. Each training date is significant and unique. Please identify your availability for all training dates.

	YES, I can attend during the allocated timeframes.	No, I cannot attend during the allocated timeframes.
Thursday, January 7, 2021 Moonshot Training 8:00 AM - 5:00 PM Gateway Training	Thursday, January 7, 2021 Moonshot Training 8:00 AM - 5:00 PM Gateway Training YES, I can attend during the allocated timeframes.	Thursday, January 7, 2021 Moonshot Training 8:00 AM - 5:00 PM Gateway Training No, I cannot attend during the allocated timeframes.
Thursday, January 14, 2021 Moonshot Training 8:00 AM - 5:00 PM Statewide Change Challenge Forum Accelerating Government Innovation through Moonshot Projects	Thursday, January 14, 2021 Moonshot Training 8:00 AM - 5:00 PM Statewide Change Challenge Forum Accelerating Government Innovation through Moonshot Projects YES, I can attend during the allocated timeframes.	Thursday, January 14, 2021 Moonshot Training 8:00 AM - 5:00 PM Statewide Change Challenge Forum Accelerating Government Innovation through Moonshot Projects No, I cannot attend during the allocated timeframes.
Thursday, January 21, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Change Leadership	Thursday, January 21, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Change Leadership YES, I can attend during the allocated timeframes.	Thursday, January 21, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Change Leadership No, I cannot attend during the allocated timeframes.
Thursday, January 28, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Risk Intelligence	Thursday, January 28, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Risk Intelligence YES, I can attend during the allocated timeframes.	Thursday, January 28, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Risk Intelligence No, I cannot attend during the allocated timeframes.
Thursday, February 4, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Digital Upskilling	Thursday, February 4, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Digital Upskilling YES, I can attend during the allocated timeframes.	Thursday, February 4, 2021 8:00 AM - 11:00 AM Statewide Change Challenge Forum Accelerating Government Innovation through Digital Upskilling No, I cannot attend during the allocated timeframes.
Thursday, Feb. 11, 2021 Moonshot Training 8:00 AM – 5:00 PM Statewide Change Challenge Forum Accelerating Government Innovation through Intrapreneurship	Thursday, Feb. 11, 2021 Moonshot Training 8:00 AM – 5:00 PM Statewide Change Challenge Forum Accelerating Government Innovation through Intrapreneurship YES, I can attend during the allocated timeframes.	Thursday, Feb. 11, 2021 Moonshot Training 8:00 AM – 5:00 PM Statewide Change Challenge Forum Accelerating Government Innovation through Intrapreneurship No, I cannot attend during the allocated timeframes.
Thursday, March 11, 2021 Moonshot Training 8:00 AM - 2:00 PM	Thursday, March 11, 2021 Moonshot Training 8:00 AM - 2:00 PM YES, I can attend during the allocated timeframes.	Thursday, March 11, 2021 Moonshot Training 8:00 AM - 2:00 PM No, I cannot attend during the allocated timeframes.
Thursday, March 25, 2021 Champion Summit 8:00 AM- 11:00 AM	Thursday, March 25, 2021 Champion Summit 8:00 AM- 11:00 AM YES, I can attend during the allocated timeframes.	Thursday, March 25, 2021 Champion Summit 8:00 AM- 11:00 AM No, I cannot attend during the allocated timeframes.
Thursday, April 8, 2021 Moonshot Training 8:00 AM - 2:00 PM	Thursday, April 8, 2021 Moonshot Training 8:00 AM - 2:00 PM YES, I can attend during the allocated timeframes.	Thursday, April 8, 2021 Moonshot Training 8:00 AM - 2:00 PM No, I cannot attend during the allocated timeframes.
Thursday, April 22, 2021 Cal-IPGCA Hackathon 8:00 AM – 5:00 PM	Thursday, April 22, 2021 Cal-IPGCA Hackathon 8:00 AM – 5:00 PM YES, I can attend during the allocated timeframes.	Thursday, April 22, 2021 Cal-IPGCA Hackathon 8:00 AM – 5:00 PM No, I cannot attend during the allocated timeframes.
Thursday, May 6, 2021 Moonshot Training 8:00 AM – 5:00 PM	Thursday, May 6, 2021 Moonshot Training 8:00 AM – 5:00 PM YES, I can attend during the allocated timeframes.	Thursday, May 6, 2021 Moonshot Training 8:00 AM – 5:00 PM No, I cannot attend during the allocated timeframes.
Thursday, June 10, 2021 Day of Innovation 8:00 AM – 5:00 PM	Thursday, June 10, 2021 Day of Innovation 8:00 AM – 5:00 PM YES, I can attend during the allocated timeframes.	Thursday, June 10, 2021 Day of Innovation 8:00 AM – 5:00 PM No, I cannot attend during the allocated timeframes.

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* 8. CalHR ENGAGE LMS: A series of 22 training modules that run in tandem with moonshot project development during the training program. These modules are taught by the State of California leadership. These modules are aligned with CalHR’s 9 Leadership Values to create a common language of leadership and innovation that transcends departmental boundaries (Note: Identifying that a specific leadership value "needs development" will not hinder a candidate's consideration, but it does provide guidance in developing balanced teams.)

	Needs Improvement	Moderately Skilled	Highly Skilled
Communicate Effectively – As demonstrated by strong writing, verbal and listening skills to create an open and transparent environment for the exchange of information.	Communicate Effectively – As demonstrated by strong writing, verbal and listening skills to create an open and transparent environment for the exchange of information. Needs Improvement	Communicate Effectively – As demonstrated by strong writing, verbal and listening skills to create an open and transparent environment for the exchange of information. Moderately Skilled	Communicate Effectively – As demonstrated by strong writing, verbal and listening skills to create an open and transparent environment for the exchange of information. Highly Skilled
Inspire & Engage – As demonstrated by an ability to motivate loyalty to a mission or plan; challenge individuals professionally and personally to achieve goals; connect employees to the work; celebrate success.	Inspire & Engage – As demonstrated by an ability to motivate loyalty to a mission or plan; challenge individuals professionally and personally to achieve goals; connect employees to the work; celebrate success. Needs Improvement	Inspire & Engage – As demonstrated by an ability to motivate loyalty to a mission or plan; challenge individuals professionally and personally to achieve goals; connect employees to the work; celebrate success. Moderately Skilled	Inspire & Engage – As demonstrated by an ability to motivate loyalty to a mission or plan; challenge individuals professionally and personally to achieve goals; connect employees to the work; celebrate success. Highly Skilled
Develop Others – As demonstrated by a commitment to coach, guide, train, instruct, and develop team members; empowering others through a sense of shared ownership and decision-making; supporting work-life balance and employee wellbeing.	Develop Others – As demonstrated by a commitment to coach, guide, train, instruct, and develop team members; empowering others through a sense of shared ownership and decision-making; supporting work-life balance and employee wellbeing. Needs Improvement	Develop Others – As demonstrated by a commitment to coach, guide, train, instruct, and develop team members; empowering others through a sense of shared ownership and decision-making; supporting work-life balance and employee wellbeing. Moderately Skilled	Develop Others – As demonstrated by a commitment to coach, guide, train, instruct, and develop team members; empowering others through a sense of shared ownership and decision-making; supporting work-life balance and employee wellbeing. Highly Skilled
Foster a Team Environment – As demonstrated through the support and recognition of team members both professionally and personally; team oriented.	Foster a Team Environment – As demonstrated through the support and recognition of team members both professionally and personally; team oriented. Needs Improvement	Foster a Team Environment – As demonstrated through the support and recognition of team members both professionally and personally; team oriented. Moderately Skilled	Foster a Team Environment – As demonstrated through the support and recognition of team members both professionally and personally; team oriented. Highly Skilled
Exhibit Personal Credibility – As demonstrated by authenticity, confidence, consistency, courage, decisiveness, generosity, honesty, integrity, judgment and risk awareness.	Exhibit Personal Credibility – As demonstrated by authenticity, confidence, consistency, courage, decisiveness, generosity, honesty, integrity, judgment and risk awareness. Needs Improvement	Exhibit Personal Credibility – As demonstrated by authenticity, confidence, consistency, courage, decisiveness, generosity, honesty, integrity, judgment and risk awareness. Moderately Skilled	Exhibit Personal Credibility – As demonstrated by authenticity, confidence, consistency, courage, decisiveness, generosity, honesty, integrity, judgment and risk awareness. Highly Skilled
Build Collaborative Relationships – As demonstrated by a broad appreciation for collaboration in public policy engagement and fostering an inclusive environment for consensus-building and decision-making.	Build Collaborative Relationships – As demonstrated by a broad appreciation for collaboration in public policy engagement and fostering an inclusive environment for consensus-building and decision-making. Needs Improvement	Build Collaborative Relationships – As demonstrated by a broad appreciation for collaboration in public policy engagement and fostering an inclusive environment for consensus-building and decision-making. Moderately Skilled	Build Collaborative Relationships – As demonstrated by a broad appreciation for collaboration in public policy engagement and fostering an inclusive environment for consensus-building and decision-making. Highly Skilled
Improve Our Organization – As demonstrated by a commitment to drive continuous improvement for better results.	Improve Our Organization – As demonstrated by a commitment to drive continuous improvement for better results. Needs Improvement	Improve Our Organization – As demonstrated by a commitment to drive continuous improvement for better results. Moderately Skilled	Improve Our Organization – As demonstrated by a commitment to drive continuous improvement for better results. Highly Skilled
Achieve Results – As demonstrated by setting a clear vision to achieve productive results by developing plans to meet targets, leverage staff skills and solve problems.	Achieve Results – As demonstrated by setting a clear vision to achieve productive results by developing plans to meet targets, leverage staff skills and solve problems. Needs Improvement	Achieve Results – As demonstrated by setting a clear vision to achieve productive results by developing plans to meet targets, leverage staff skills and solve problems. Moderately Skilled	Achieve Results – As demonstrated by setting a clear vision to achieve productive results by developing plans to meet targets, leverage staff skills and solve problems. Highly Skilled
Model Good Governance – As demonstrated by stewardship for customer service, accountability, transparency, sustainability, policy, compliance and solid political acumen.	Model Good Governance – As demonstrated by stewardship for customer service, accountability, transparency, sustainability, policy, compliance and solid political acumen. Needs Improvement	Model Good Governance – As demonstrated by stewardship for customer service, accountability, transparency, sustainability, policy, compliance and solid political acumen. Moderately Skilled	Model Good Governance – As demonstrated by stewardship for customer service, accountability, transparency, sustainability, policy, compliance and solid political acumen. Highly Skilled

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* 9. Review and rank your Interest in the Cal-IPGCA Cohort 2021 Innovation Priorities (IPs):
Innovation Priorities (IPs) are submitted to Cal-IPGCA by the State of California Leadership. IPs represent an enterprise-wide challenge facing the State of California. Each IP represents the foundation of a teamed Moonshot Project. A Moonshot is the combination of a huge problem, a re-imagined solution to that problem, and the creation of innovative ideas that are designed to shift the approach and outcomes of people, processes, and
technology to make that solution possible. NOTE: In assessing interest, please balance your knowledge alongside your personal/professional interest, and most importantly, your passion to work on a specific innovation priority.

	Not Interested	Somewhat Interested	Very Interested
1. State Agency Collaboration Network (SACNetwork)	1. State Agency Collaboration Network (SACNetwork) Not Interested	1. State Agency Collaboration Network (SACNetwork) Somewhat Interested	1. State Agency Collaboration Network (SACNetwork) Very Interested
2. SACNetwork Memorandum of Understanding	2. SACNetwork Memorandum of Understanding Not Interested	2. SACNetwork Memorandum of Understanding Somewhat Interested	2. SACNetwork Memorandum of Understanding Very Interested
3. SACNetwork Skillsbank	3. SACNetwork Skillsbank Not Interested	3. SACNetwork Skillsbank Somewhat Interested	3. SACNetwork Skillsbank Very Interested
4. SACNetwork Innovation Corp	4. SACNetwork Innovation Corp Not Interested	4. SACNetwork Innovation Corp Somewhat Interested	4. SACNetwork Innovation Corp Very Interested
5. SACNetwork Middle Management Consortium	5. SACNetwork Middle Management Consortium Not Interested	5. SACNetwork Middle Management Consortium Somewhat Interested	5. SACNetwork Middle Management Consortium Very Interested
6. SACNetwork "Rise-up" Ambassador Corp for Homeless Children	6. SACNetwork "Rise-up" Ambassador Corp for Homeless Children Not Interested	6. SACNetwork "Rise-up" Ambassador Corp for Homeless Children Somewhat Interested	6. SACNetwork "Rise-up" Ambassador Corp for Homeless Children Very Interested
7. SACNetwork Teleworking In California (Best Available Practices)	7. SACNetwork Teleworking In California (Best Available Practices) Not Interested	7. SACNetwork Teleworking In California (Best Available Practices) Somewhat Interested	7. SACNetwork Teleworking In California (Best Available Practices) Very Interested
8. SACNetwork Beyond Racism: One System, One State, One World, One People	8. SACNetwork Beyond Racism: One System, One State, One World, One People Not Interested	8. SACNetwork Beyond Racism: One System, One State, One World, One People Somewhat Interested	8. SACNetwork Beyond Racism: One System, One State, One World, One People Very Interested

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* 10. 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. Scholarship applicants EXCLUDE this program option. It can be added at an additional cost.

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.)

I am a scholarship applicant and do not qualify for this program option.

No, do not choose to elect this package.

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* 11. Explain why you want to be considered as a Cal-IPGCA Leader, Innovator and Change Agent trainee, (or Assistant Facilitator) for Cal-IPGCA Cohort 2021. Your response is very important. It quantifies your motivation to be considered for acceptance.

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

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* 1. Applicant Information

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

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* 3. I am submitting this application to be considered for the following opportunities: (Meets the State of California’s biennial leadership training requirements. (GC 19995.4.)

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* 4. Please indicate if you are an active member of the following California organizations. (Check all that apply.)

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* 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.)

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* 6. Status of Supervisor's/Manager's Awareness of this Submission:Note: If a government registrant, applications cannot be approved without supervisor approval.

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* 7. The scheduled virtual training dates for Cal-IPGCA 2021 are listed below. Each training date is significant and unique. Please identify your availability for all training dates.

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* 11. Explain why you want to be considered as a Cal-IPGCA Leader, Innovator and Change Agent trainee, (or Assistant Facilitator) for Cal-IPGCA Cohort 2021. Your response is very important. It quantifies your motivation to be considered for acceptance.

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

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

Note: If a government registrant, applications cannot be approved without supervisor approval.