Online and Blended IMPACT Program 2022-2023 Application

The Online and Blended IMPACT (Instructors Magnifying Potential and Cultivating Transformation) Program is designed for current and pre-service K-14 educators, administrators, TOSAs, and trainers. Participants who complete the program will earn 15 quarter units of continuing education over two Foothill College quarters and become California State Certified as an Online and Blended Instructor.

Early applicants who submit their application by Sunday, September 11 will be notified if accepted early.
All other applications must be submitted by Sunday, September 18, 2022!

This program is 100% tuition-free for CA residents thanks to the generous donations of our KCI community. NOTE: If accepted, you will need to pay a $75 registration fee to secure your place. *Out-of-state applicants will incur a per-unit fee

LOCATIONS & DATES

This program is online and includes six synchronous sessions on Tuesday October 4, November 8, December 6, January 10, February 7, and March 7 from 5:00 PM to 7:30 PM. Attendance is mandatory, and you must attend all six unless there is an emergency that prevents you from doing otherwise. The program officially begins September 26, 2022 and ends March 24, 2023.

💥HEADS UP: This application includes short answers and a performance task. Please review and compose your answers in a second document, using the application PDF on the KCI OBI Program Website. When you are ready, come back here and copy/paste your answers.

If you have questions about the application, send an email to Director of Programs and Partnerships, Justin Sewell, at jsewell@krauseinnovationcenter.org.

First name*

Last name*

Email*

Work email

Home Street Address (Including Apt or Unit #)*

City*

State/Region*

Postal code

Phone number

Gender*

CWID

If you have taken any LINC classes through Foothill College of the KCI previously, please provide your student ID below. If you do not remember your student ID, leave the field blank (do not list your Social Security Number.)

If someone recommended that you apply for the OBI program, please let us know who!

Name of Co-Applicants (if applicable)

If you are applying with others as a team, please include their names in the text box below. Remember that all applications are considered individually, so each member of the team will need to apply separately, and each application will be reviewed independently. (Note: Each person should provide their own unique responses - do not share/copy your responses.)

Teaching Experience

Current School Site*

Is your school considered Title 1?*

Job title*

Are you currently a K-12 teacher?*

Yes

Current School District*

Number of Years in Education*

Short Answer Section

Please answer each question with 500 characters or less. (Approx. 3-4 sentences.)

Q1. Describe an online, blended, or tech-forward lesson that you have created that has integrated technology in a way that truly empowered your learners.*

Q2. What is one experience you've had this past year that highlights your commitment to equity and access for all learners?*

Q3. What's an impactful online or blended professional learning experience you've had recently, and what ah-ha did you experience because of it?

Learning happens everywhere! Consider social media, books, articles, webinars, classes, videos, etc. There's no wrong way to learn!

Q4. What is the benefit of this program to you in your education career?

(promotion, units/salary scale, unlocking a new position, switching careers, more leadership exposure, etc.)

Q5. How did you hear about this program?

Confirmations and Agreements

Please confirm your understanding and commitment to completing the following program requirements, should you be accepted.

**By marking the statement, you understand and agree to the expectation.

(A) I understand and agree to attend and participate in all required synchronous meetings of the OBI Program.*

(B) I understand and agree to attend and participate in all required synchronous meetings of the OBI Program.*

(D) I understand that I will need to pay a $75, non-refundable fee to participate the program (after acceptance to the program).*

(E) I understand that this program is a purely donor-funded program. Donors check in and like to see our photos on our site and in our published works, including participant electronic portfolios. I am consenting to the sharing of my projects, reflections, and photos of participation during the program.*