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Shaheen A. Wirk~`~/ 1 ~ ~~ ~ C11°Y OF MIAMI BEACI~ _ IC)~eRD AND COMMITTEE APPL.ICATIOI~ FORM NAME: Wirk Shaheen A Last Name First Name Middle Initial HOME ADDRESS: 1508 400 Alton Road Miami Beach FL 33139 No. Street City State Zip Code PHONE: __ 917 593 1296 786 276 2465 212-918-0759 saw9(~D_alumni.duke.edu Home Work Fax Email address Business Name: Bridger Management Position: Healthcare Analyst Address: 400 1111 Lincoln Road Miami Beach FL 33139 o. treet ity tate ip o e Professional License (describe) Expires: Attar>It a cr~py of ttae tiecnss Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months: Yes • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes • Are you a registered voter in Miami Beach: Yes . (Please circle one): I am now a resident of: South Beach • Are you a politically or registered lobbyist with the City of Miami Beach: No • I am applying for an appointment because I have special abilities, knowledge, experience. Please list below: I have a background, education, and knowledge of both healthcare and business and would like to do something for the city in this regard. PiPa~P iist your preferences in order of ranking i11 first choice (2] second choice, and [3] third choice. Please note that only three (31 choices will be observed by the City Clerk's Office. (Regular Boards of City) Affordable Housin Adviso Committee Historic Preservation Board" Art in Public Places Committee Housin Authorit " Beach Preservation Board Loan Review Committee` Beautification Committee Marine Authorit " Board of Ad'ustment* Miami Beach Commission for Women Bud et Adviso Committee Miami Beach Cultural Arts Council Ca ital Im rovements Oversi ht Miami Beach Florida Sister Cities Committee on Homeless Normand Shores Local Gov't Nei h. Im rovement Committee for Qualit Education in MB Parks and Recreation Facilities Board Communit Develo ment Adviso Personnel Board" Communit Relations Board Plannin Board Convention Center Adviso Board Police Citizens Relations Committee Cultural Arts Nei hborhood District Overla CANDO Production Indust Council Debarment Committee Public Safet Adviso Committee Desi n Review Board* Safet Committee Disabilit Access Committee Sin le Famil Residential Review Panel Fine Arts Board Sustainabilit Committee Ga Business Develo m@nt Ad Hoc Trans arenc Reliabili & Accountabilit Committee "TRAC" Golf Adviso Committee ~ ~ ~ - ~;1 , "1 Trans ortation and Parkin Committee 1 Health Adviso Com i ee Visitor and Convention Authorit '" 2 Health Facilities Auth Youth Center Adviso Board His anic Affairs Committee "~ ;~ ; ~ , "Board Required to File State Disclosure form . i..s r''. u. ~,. _ ~ ~tL~~~.~1 ~~ttinc~s,Tetriporary intem~t ~ii9s;O~I~317~aBCRp}~Sh~heen`J?1=,rk4_6_2{7i7~7483~1PM.docx ~~ Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: No Years of Service: 2. Present participation in Youth Center activities by your children? No. If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: Program: Child's name: Age: Program: .Have you ever been convicted of a felony: No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: No If yes, please explain in detail: . Do you currently owe the City of Miami Beach any money: No If yes, explain in detail • Are you currently serving on any City Boards or Committees: No If yes; which board? . What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: Name: Title: • List all properties owned or have an interest in, which are located within the City of Miami Beach: 400 Alton Road, Apt 1508 • I am now employed by the City of Miami Beach: No Which department? • Pursuant to City Code Section 2-25 (b): Do you have a who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): Gender: Male Ethnic Origin (Check one) Asian or Pacific Islander Race: Physically Challenged: No °'"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." The City Clerk's Office reserves the right to contact you for verification purposes. I Shaheen Wirk agreed to the following terms on 4/6/2009 7:48:30 PM Please attach a copy of your resumeto this application NOTE:Applications will remain on file for a period of one (1) calendar year. r.Y_~_....... _..a Oa..4. ...• Fmnlnvnrl (1thPr' ~niNivynicin v~a~ua. Received in City Clerk's Office by ®/V ~C ~~ Date Name of Deputy Clerk _ 17 ~ g Document Control Number (Assigned by the City Clerk's Office) ~ Entered By Date Revised 09/02/08 LH C~ivc~ct~~~cants anc! Sivti(ng~;clerrnarm'_l~aca! Settin~s~7emporary Interndt Fil@~~Oi_K317;BCAppShaheenWirk4_6_2fl097483APM.docx sx~EN wry 400 Alton Road, # 1508 Miami, FL 33139 {917)593-1296 saw9@alumni.duke.edu Employment BRIDGER MANAGEMENT, New York, NY /Miami, FL 2001 -present Healthcare Analyst: Evaluate novel drugs, procedures, and devices that impact the pharmaceutical, biotechnology, hospital, and medical device industries with an eye towards navel, innovative, or disruptive technologies. Focus on underlying science, markets, competitive dynamics, intellectual property, and reimbursement. Follow the scientific literature, interact with experts, and attend medical conferences to support the investment decision making process. 2000 - 2001 MERCURY MD, Durham, NC Business Development Associate: Aided senior management in developing and executing corporate strategy to target investors and clients, completed due diligence on various projects, and overhauled business plan which was then distributed to potential investors securing additional capital investments. 1998 - 2001 KAPLAN TESTING CENTERS, Durham, NC Teacher: Taught biology, chemistry, math, and verbal sections to over 150 MCAT, DAT, and GMAT students. Education DUKE UNIVERSITY, The School of Medicine /The Fuqua School of Business, Durham, NC 1998 - 2003 Joint degree of Doctor of Medicine, Master of Business Administration {MD /MBA), May 2003. Health Sector Management concentration. Awarded Fuqua Fellowship and Thomas F. Frist, M.D. Scholarship. 1994 -199$ DUKE UNIVERSITY, Durham, NC Bachelor of Science, Biology, with minors in Chemistry and Religion, May 1998. Magna Cum Laude. Robert C. Byrd Scholar. Duke Student Government Legislator. Freshmen Advisory Counselor Program Board Member. Rothermere Scholar, New College, Oxford University, England. Studied at Duke Marine Laboratory, Beaufort„ NC. 1990 - 1994 CARROLL HIGH SCHOOL, Dayton, OH Graduated Valedictorian, June 1994 Activities ROBERTSON SCHOLARS PROGRAM, Durham and Chapel Hill, NC 2002 -present Selection Committee Member: Aid in the selection and interviewing of potential scholarship recipients. 2006 -present DUKE UNIVERSITY ALUMNI ADMISSIONS, Miami, FL Interviewer: Interview and evaluate local undergraduate applicants to Duke University. 2002 - 2003 MEDICAL SCHOOL JUDICIAL BOARD, Dwham, NC Judfcial Board Representative: Evaluated cases of academic dishonesty. Participated in honor code revisions. 2001 - 2002 MEDICAL SCHOOL ADMISSIONS COMMITTEE, Durham, NC Executive Committee Member: Screened, interviewed, and evaluated applicants with voting privileges at biweekly meetings. Recruited and coordinated admissions volunteers. Planned recruiting weekend for admitted applicants. 2001 - 2003 DAVISON COUNCIL, Durham. NC Representative: Served as liaisons between the administration and the medical school student body and aided in ongoing projects or initiatives through participation in task forces or ad hoc committees. Research DUKE UNIVERSITY SCHOOL OF MEDICINE, Durham, NC 2001 - 2004 Publication: Oxygen Transport Dynamics After Resuscitation With a Conjugated Hemoglobin Solution. Arch Surg. 2004;139:SS-60. Co-authored paper with Dr. Steven Vaslef. Summer 1997 THE UNIVERSITY OF TEXAS M,D, ANDERSON CANCER CENTER, Houston, TX Project title: Effect of Various Stressors on Expression of Cell Surface Proteins in Human Tumor Cells. Data presented at 25'" Annual San Antonio Breast Cancer Symposium in October 2006. Fall 1996 DUKE UNIVERSITY MARINE LABORATORY, Beaufort, NC Project Title: How the Sand Fiddler Crab Finds Its Burrow: An Example of ldiathetic Orientation. Summer 1996 RABIN MEDICAL CENTER, Aetach Tikvah, Israel Project title: Assessment of Allelic Loss of Chromosome 18q in Colorectal Carcinomas.