C ity of Costa Mesa Application for Committee/Commission Appointment 1 / 2
Q1
Full Name:
Rocky Evans
Q2
Indicate the name of the Committee/Commission you are
interested in serving on:
Cultural Arts Committee
Q3
Indicate why you wish to serve on this Committee/Commission. Provide any experience or qualifications you may possess that you think would be beneficial to this Committee/Commission. A resume (optional) may be attached.
I have been on the Cultural Arts Committee since 2015 and have enjoyed my time. I have also served on a non profit organization as a Treasurer and am the current present of a local homebrew club. I take pleasure in spending my time creating events or experiences for other people to enjoy.
Q4
As a Committee/Commission member, what ideas or projects are of interest to you? I really like our Utility Box program and am currently on the subcommittee. I'd like to help bring back some in-person experiences post-covid, like the "Action Arts in the Parks"
Q5
Optional Resume:
Respondent skipped this question
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Collector:Collector: Web Link 1 Web Link 1 (Web Link)(Web Link) Started:Started: Tuesday, February 15, 2022 11:50:18 AMTuesday, February 15, 2022 11:50:18 AM Last Modified:Last Modified: Tuesday, February 15, 2022 12:01:49 PMTuesday, February 15, 2022 12:01:49 PM Time Spent:Time Spent: 00:11:3100:11:31
IP Address:IP Address: 76.91.68.23676.91.68.236
ATTACHMENT 4
City of Costa Mesa Application for Committee/Commission Appointment 1 / 2
Q1
Full Name:
Charlene Ashendorf
Q2
Indicate the name of the Committee/Commission you are
interested in serving on:
Cultural Arts Committee
Q3
Indicate why you wish to serve on this Committee/Commission. Provide any experience or qualifications you may possess that you think would be beneficial to this Committee/Commission. A resume (optional) may be attached.
With the hiring of the City's first Art Specialist, I desire to continue to serve on the committee to provide input on the implementation of the city's Arts & Culture Master Plan during a critical time for the participation of the CAC. I have served as the Chair of the CAC for the last year and have had several years experience with the Master Plan process.
Q4
As a Committee/Commission member, what ideas or projects are of interest to you? As a current committee member, one of the initiatives I have been able to have approved for a 2022 goal is to launch our first literary event to include a partnership with Orange County Public Library. The time to include and expand to literary arts is now! Q5
Optional Resume:
CAC APPLICATION.docx (14KB)
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COMPLETECOMPLETE
Collector:Collector: Web Link 1 Web Link 1 (Web Link)(Web Link) Started:Started: Saturday, February 12, 2022 5:27:03 PMSaturday, February 12, 2022 5:27:03 PM Last Modified:Last Modified: Thursday, February 17, 2022 5:44:41 PMThursday, February 17, 2022 5:44:41 PM Time Spent:Time Spent: Over a dayOver a day
IP Address:IP Address: 107.184.184.97107.184.184.97
February 17, 2022
City Clerk’s Office
City of Costa Mesa
P. O. Box 1200
Costa Mesa, CA 92628
RE: Application to the Cultural Arts Committee
Dear Mayor Stephens and Members of the Costa Mesa City Council:
What a year it has been for the City of the Arts! Covid, need I say more? Yes there is plenty to say.
In spite of the challenges, there were many important accomplishments of the Cultural Arts Committee.
Utility boxes continued to be approved, wrapped and placed around town. Small grants were approved including one to support the restoration of the Home on the Range mural which will begin soon. New artists were returned and featured at the city galleries and ARTventure , “In the Time of Covid” went virtual for the first time!
As I finish out my term on the Cultural Arts Committee, I believe now, more than ever ensuring that appointing a member who has served on the committee in a leadership role is very important. We are embarking on an historic time with the hiring of the long-awaited art specialist and experienced committee members will be important during this time.
The Cultural Arts Committee is truly a hands-on, working group of volunteers who have accomplished much in the past couple of years and are living into the tagline, City of the Arts. But there is much to do.
I, too, have grown in this position. Just recently I represented the CAC at the tri-city Leadership Tomorrow Arts Day. I felt the interest and enthusiasm from these future leaders! I also believe my work as Visual and Performing Arts Commissioner for the NMUSD has resulted in stronger partnerships, more program opportunities and solid relationships.
Why do I wish to serve? Because this "work" ignites a fire in my soul. I enjoy the work of the committee and want to continue to elevate the platform of arts in Costa Mesa! This art train is moving forward, and I want to be part of this movement for the good of our city! It is my belief that with the continued support of our Mayor and City Council, the talented staff, a well- rounded and active volunteer committee, Costa Mesa will continue to realize a city of the arts beyond imagination.
Most Sincerely,
Charlene M. Ashendorf
City of Costa Mesa Application for Committee/Commission Appointment 1 / 2
Q1
Full Name:
brian buckner
Q2
Indicate the name of the Committee/Commission you are
interested in serving on:
Parks, Arts and Community Services Commission
(Districts 3)
,
Housing & Public Service Grants Committee,
Animal Services Committee,
Bikeway and Walkability Committee,
Cultural Arts Committee,
Historical Preservation Committee
Q3
Indicate why you wish to serve on this Committee/Commission. Provide any experience or qualifications you may possess that you think would be beneficial to this Committee/Commission. A resume (optional) may be attached.
I want to be able to serve my local community. Currently don't have experience with local politics.
Q4
As a Committee/Commission member, what ideas or projects are of interest to you? The Arts in Costa Mesa.
Q5
Optional Resume:
Respondent skipped this question
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COMPLETECOMPLETE
Collector:Collector: Web Link 1 Web Link 1 (Web Link)(Web Link) Started:Started: Tuesday, March 01, 2022 11:38:11 AMTuesday, March 01, 2022 11:38:11 AM Last Modified:Last Modified: Tuesday, March 01, 2022 11:40:39 AMTuesday, March 01, 2022 11:40:39 AM Time Spent:Time Spent: 00:02:2700:02:27
IP Address:IP Address: 107.184.190.76107.184.190.76
City of Costa Mesa Application for Committee/Commission Appointment 1 / 2
Q1
Full Name:
Justin Fong
Q2
Indicate the name of the Committee/Commission you are
interested in serving on:
Cultural Arts Committee
Q3
Indicate why you wish to serve on this Committee/Commission. Provide any experience or qualifications you may possess that you think would be beneficial to this Committee/Commission. A resume (optional) may be attached.
My name is Justin Fong and I am interested in serving on the Cultural Arts Committee. I graduated from UCSD, majoring in International Studies and minoring in Photography, and received my JD/MBA from Washington University in St. Louis. I am currently the General Counsel of a mortgage lender and have experience in legal matters including commercial litigation and intellectual property.
I am also a Board of Director for the Orange County Asian American Bar Association. I believe that based on my background in law, business, and community service, I have the necessary hard skills to serve on the Committee and help execute the necessary planning to help our community thrive.
Much more importantly though, I have a strong affinity for the arts. As an art minor, I spent countless hours studying and practicing art, with my focus being photography. During my junior year of college, I went abroad to further my art studies in Paris. Furthermore, I worked over my college summers as a Getty Intern, where I was exposed to the art and museum community. #13#13
COMPLETECOMPLETE
Collector:Collector: Web Link 1 Web Link 1 (Web Link)(Web Link) Started:Started: Wednesday, February 16, 2022 5:01:45 PMWednesday, February 16, 2022 5:01:45 PM Last Modified:Last Modified: Wednesday, February 16, 2022 5:52:04 PMWednesday, February 16, 2022 5:52:04 PM Time Spent:Time Spent: 00:50:1900:50:19
IP Address:IP Address: 38.79.67.238.79.67.2
C ity of Costa Mesa Application for Committee/Commission Appointment 2 / 2
Q4
As a Committee/Commission member, what ideas or projects are of interest to you? As an avid arts lover, I believe the committee has done an amazing job at providing for the city. If chosen to be a member of the committee, my goal would be to help supplement the great work the committee has already done. Here are a few ideas I have. 1) Large Outdoor Art Classes
One idea would be to have once a month or a quarter a large scale art event where we have a local artist, or I was thinking of potentially one of the cities muralists (we could make this a condition of being accepted as a muralist), give a short 30min-1hour art lesson outside. I think it would be a great way to introduce people to the arts and also give them a connection to the murals that are painted.
2) Connecting Generations
Events with elder people and young people. I think that there is a disconnect between the generations and it would be great to have events where young people get to learn from older folk. Senior citizens often have a vast wealth of knowledge and it would be great to have classes taught by them in areas such as woodworking or knitting.
Q5
Optional Resume:
Respondent skipped this question
Q6
Contact Information:Note: This contact information will not be posted on the City's website or distributed to the public.
However, this information is still subject to release pursuant to the California Public Records Act.
Name: Justin Fong
Address:
City/Town:
ZIP/Postal Code:
Email Address:
Phone (cell):
Q7
Signature Required
By checking this box and typing my name below, I am
electronically signing my application.
Q8
Full Name:
Justin Fong
City of Costa Mesa Application for Committee/Commission Appointment 1 / 2
Q1
Full Name:
Respondent skipped this question
Q2
Indicate the name of the Committee/Commission you are
interested in serving on:
Parks, Arts and Community Services Commission
(Districts 3)
,
Housing & Public Service Grants Committee,
Cultural Arts Committee
Q3
Indicate why you wish to serve on this Committee/Commission. Provide any experience or qualifications you may possess that you think would be beneficial to this Committee/Commission. A resume (optional) may be attached.
Homeless issue in Costa Mesa needs advocacy, innovative solutions to work with those already being implemented.
Q4
As a Committee/Commission member, what ideas or projects are of interest to you? Poetry Workshops for kids and adults, homeless as well.
Q5
Optional Resume:
Respondent skipped this question
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COMPLETECOMPLETE
Collector:Collector: Web Link 1 Web Link 1 (Web Link)(Web Link) Started:Started: Monday, February 07, 2022 5:36:36 AMMonday, February 07, 2022 5:36:36 AM Last Modified:Last Modified: Monday, February 07, 2022 5:43:04 AMMonday, February 07, 2022 5:43:04 AM Time Spent:Time Spent: 00:06:2800:06:28
IP Address:IP Address: 172.58.139.173172.58.139.173
City of Costa Mesa Application for Committee/Commission Appointment 1 / 2
Q1
Full Name:
Hengameh Abraham
Q2
Indicate the name of the Committee/Commission you are
interested in serving on:
Finance and Pension Advisory Committee,
Bikeway and Walkability Committee,
Cultural Arts Committee
Q3
Indicate why you wish to serve on this Committee/Commission. Provide any experience or qualifications you may possess that you think would be beneficial to this Committee/Commission. A resume (optional) may be attached.
Serving the city in any capacity is a passion of mine & I would love the opportunity to serve at either committees Q4
As a Committee/Commission member, what ideas or
projects are of interest to you?
Respondent skipped this question
Q5
Optional Resume:
inbound7380946663576053567.docx (11.2KB)
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Collector:Collector: Web Link 1 Web Link 1 (Web Link)(Web Link) Started:Started: Saturday, February 26, 2022 3:32:48 PMSaturday, February 26, 2022 3:32:48 PM Last Modified:Last Modified: Saturday, February 26, 2022 3:35:36 PMSaturday, February 26, 2022 3:35:36 PM Time Spent:Time Spent: 00:02:4700:02:47
IP Address:IP Address: 107.119.53.35107.119.53.35
28188 Moulton Pkwy, Apt2418
Laguna Niguel, CA, 92677
949-294-2584
[email protected]
HENGAMEH SEYRAFI
OBJECTIVE An opportunity to apply my 11 years of experience as a pharmacy technician.
SKILLS & ABILITIES
● Accurate data entry skills
● Able to read, write, and speak English fluently
● Strong time management and organizational skills
● Excellent communication skills, both orally and in writing ● Willingness to be a team player and promote a positive team environment ● Excellent attention to detail
● Flexible and proactive to meet varied patient needs
● Self-motivated and able to work independently
● Able to effectively present information to the patient and in small group situations ● Dedicated to excellence and quality
● Able to collaborate with other healthcare professionals ● Strong interpersonal and “people” skills
● Experienced in Microsoft Office (Word, Excel, Outlook, etc.) ● Able to add, subtract, multiply, and divide in all units of measure; this may include using whole numbers, common fractions, and decimals and being able to compute rate, ratio, and percent
EXPERIENCE Nysansa Learning Corporation
640 N. Tustin Ave #101, Santa Ana, CA, 92705
Behavioral Therapist
MedlIfe Pharmacy & Compounding April 2016 to April 2018 6644 Irvine Center Drive, Irvine, CA, 92618
949-502-7272
Lead Tasks as a lead pharmacy technician.
Monitor and prioritize workflow of pharmacy technicians, including billing activities.
Prepare dosage medications for dispensing into bottles and unit dose packaging.
Assist in preparing and dispensing medication under direct supervision of Pharmacist.
Filing prior authorization forms and submitting them, submitting Medi-Cal TAR forms.
Wal-Mart Pharmacy October 2005 to March 2014 and September 2015 till December 2015
27470 Alicia Pkwy, Laguna Niguel, CA, 92677
949-360-0923
Supervised technicians and clerks as a lead technician.
Inventory for control and non-control medications.
Scheduling and replacing floating pharmacist and technicians when needed.
Ordering medications and OTC meds daily for inventory.
Customer service for patients who have complaints and concerns.
Billing insurances of all types from Medical, Medicare, and private insurances and submitting prior authorization forms when needed.
Contacting prescribers for medication verification and/or change of medication when needed.
On maternity leave from May 2014 till September 2015
EDUCATION Bachelor of Science in Health Sciences
California State University of Fullerton, Graduation Date: January 2012 High School Diploma, Mission Viejo High School, June 2004 PTCB Certificaiton 410101070950389
California Pharmacy Technician License: 80290
REFERENCES
Jason Berg, PharmD
Supervisor and pharmacy manager at Walmart
949-374-1251
[email protected]
Christian Harrison, PharmD
949-293-9792
[email protected]