Colorado Judicial Department

Employment Application

Thank you for your interest in employment with the Colorado Judicial Department. A clear
understanding of your background and work history is imperative to effectively evaluate your
qualifications. The completion of this application represents your ability to provide written or typed
communication and follow directions. Your completed application is the primary source of
information for making selection decisions and you may be evaluated solely on the information
provided.

Instructions and Information:

1. Employment applications must be received or postmarked by the announced closing date. Late
applications will not be accepted.

2. A separate Colorado Judicial Department Employment Application must be submitted for each
position opening.

3. Print or type your employment application clearly. Incomplete or illegible applications may not be
accurately reviewed.

4. Attach supplemental sheets, if necessary, to complete your application.

5. All submitted Colorado Judicial Department Employment Applications must be signed by the
applicant, certifying that all statements are true and complete. An unsigned application may be rejected.
(For applications submitted electronically, your typed name will serve as your official signature certifying
the contents of the application) If at any time any information provided in the employment application is
determined to be false, you may be subject to immediate termination.

6. Resumes are encouraged. However, they will only be considered as a supplement to the Colorado
Judicial Department Employment Application, and the information contained within the resume may or
may not be used to award points during the application review. Resumes sent in lieu of the application will
not be considered.

7. Submitting an employment application does not mean you will be interviewed or hired.

8. Once submitted, notify the office to which you submitted an employment application of any change
in name, address, telephone number or availability.

9. If you are offered employment, your appointment will be conditional, subject to the results of a
routine background investigation, including a criminal history check.
 Colorado Judicial Department | Employment Application
10. If you are hired, the Immigration Reform and Control Act requires that you provide proof within three
work days of your eligibility to work in the United States. Failure to do so may result in immediate
termination.

The Colorado Judicial Department is an Equal Opportunity Employer

Colorado Judicial Department Employment Application | Page 2 of 15

 Colorado Judicial Department | Employment Application

EMPLOYMENT APPLICATION DATA

Position Title as Advertised: Court Judicial Assistant

Position Number as Advertised: 21125

Monthly Salary Required: $1,122.00 - $2,024.00 / Month

Type of Employment Preferred: Full-time Part-time Temporary Contract
Employment
Date Available to Begin Employment: 05/20/2011

DEMOGRAPHIC DATA
Name: Hefley Lisa Christine      
Last Name First Name Middle Name Suffix

List other name(s) under which you have been employed: Lisa C. Potter

Complete Address: 2610 S. 81st Lane Phoenix AZ 85043

Street/P.O. Box City State Zip Code

Contact Information: Home (     )       Work (     )       Cell ( 623 ) 225-4479
Email: lisa.c.potter@asu.edu or mommypotter@yahoo.com

RECRUITMENT INFORMATION
Please check the applicable box(es) indicating how you learned about the position.
Colorado Judicial Branch Website
Posted Announcement at Courthouse
(www.courts.state.co.us)
Other Website: If so, which one?
monster.com jobing.com whohascourtjobs.com Posted Announcement at State Agency Office
Other:      

Friend / Relative Posted Announcement at Workforce Center

Current Judicial Branch Employee Other:      

Colorado Judicial Department Employment Application | Page 3 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa
PERSONAL DATA
For any of the following questions to which you reply “YES”, please explain and provide
detailed information under “Additional Data” below.

1. Yes No Are you now or have you ever been a Colorado State Employee?

2. Yes No Have you ever worked for the Colorado Judicial Department?

3. Yes No If you have applied for previous positions, have you ever taken a test with the Colorado Judicial
Department?

4. Yes No If presently employed, do you have a problem with us contacting your employer?

5. Yes No Do you have any commitments to another employer or organization which might interfere with or
affect your employment with us?

6. Yes No Have you ever received a corrective and/or disciplinary action from an employer?

7. Yes No Have you ever been terminated, fired, forced or asked to resign from a job?

8. Yes No Is your current driver’s license suspended or revoked, or are you otherwise unable to legally drive in
Colorado?

9. Yes No Have you ever been convicted of a felony; a misdemeanor; or any traffic or petty offense involving
drugs or alcohol? Please include all of these convictions regardless of date. Conviction means a finding of guilt
by a judge or jury; entering a plea of guilty or no contest (nolo contendre) or entering into a deferred sentence where the sentence is still
deferred or the case is still pending.

10 Yes No Do you have any criminal charges currently pending, including felonies; misdemeanors; or any
. traffic/petty offenses where alcohol or drugs are alleged to be involved?

11 Yes No Do you object to submitting to a criminal history background check?

.

ADDITIONAL PERSONAL DATA

For any of the previous questions under the “Personal Data” section to which you replied “YES”,
include the number of the question to which you are responding and a detailed explanation.

9. I plead guilty to one count of Endangerment in November 2008. The conviction has since been set aside.

Colorado Judicial Department Employment Application | Page 4 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa
REFERENCES
List three persons whom we may contact who are NOT related to you and who have
definite knowledge of your qualifications and fitness for the position for which you are applying.
Full Name Complete Present Address Contact Information Business / Occupation
Karla Meade 7770 W. LaMar Rd. Daytime Phone #: ( 623 ) 205- Student Teacher
9446
Glendale AZ 85303
Email:
KarlaMeade@yahoo.com
Sean Heal 7233 W. Shabutte Daytime Phone #: ( 602 ) 859- Sales
2783
Peoria AZ 85345
Email:
Seanersjeep@yahoo.com
Kelli Malm 344 Mason Ct. Daytime Phone #: ( 815 ) 793- College Student
4777     
Sycamore IL 60178

Email: kmalm@yahoo.com

EDUCATION AND TRAINING

If the position for which you applied requires a college degree, a transcript of
your college credits may be requested prior to an offer of employment.

Highest Grade Completed: Currently Senior at Arizona State University

Name and location (city and state) of last high school attended: Trevor G. Browne High School Phoenix, AZ
Did you graduate from high school? Yes No If not, did you receive a GED? Yes No
If you received a GED, what is the GED certificate number?      
Issued by:      

UNIVERSITY / COLLEGE
(Undergraduate, Graduate, Post Graduate)
Name of Educational Institution: Location: Attended (month/year):
Arizona State University Phoenix/Tempe Arizona From 07/07 To 05/11
Degree Awarded: Date: Major Field of Study: Minor Field of Study: Completed # of Hours:
108/120
Bachelor of
05/04/11 Criminal Justice       Semester Quarter
Science

Colorado Judicial Department Employment Application | Page 5 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa
UNIVERSITY / COLLEGE (continued)
Name of Educational Institution: Location: Attended (month/year):
            From       To      
Degree Awarded: Date: Major Field of Study: Minor Field of Study: Completed # of Hours:      
                        Semester Quarter

Name of Educational Institution: Location: Attended (month/year):

            From       To      
Degree Awarded: Date: Major Field of Study: Minor Field of Study: Completed # of Hours:      
                        Semester Quarter

BUSINESS, TRADE, TECHNICAL, VOCATIONAL OR MILITARY TRAINING

Name of Training Institution: Location: Attended (month/year):
            From       To      
Title of Program or Subjects Taken: Total Classroom Hours: Certificate Received: Completed # of Hours
     
            Yes No
Semester Quarter
Name of Training Institution: Location: Attended (month/year):
            From       To      
Title of Program or Subjects Taken: Total Classroom Hours: Certificate Received: Completed # of Hours
     
            Yes No
Semester Quarter
Name of Training Institution: Location: Attended (month/year):
            From       To      
Title of Program or Subjects Taken: Total Classroom Hours: Certificate Received: Completed # of Hours
     
            Yes No
Semester Quarter

Colorado Judicial Department Employment Application | Page 6 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa

OFFICE SKILLS
Typing Skills
None 30-39 net WPM 45-50 net WPM 61-70 net WPM
71 or more net
Less than 30 net WPM 40-44 net WPM 51-60 net WPM
WPM
List all legal research, word processing and/or software programs are you proficient in (e.g., Word, Excel,
etc.):
My research experience is limited to course work in my criminal justice program. I am excellent in
MS Word. I have used other programs in the past and I am very quick to learn new programs.
If you have prior Court and/or Probation experience, in which processing software are you proficient
(e.g., Eclipse/Icon, etc.)?
None
List other specific qualifications or skills (e.g., honors, awards, internships, fellowships, publications, etc.).
I have been running my own business successfully for 6 years. I am very self motivated and able to
perform tasks with minimal or no supervision.

LICENSES / CERTIFICATION / REGISTRATION

If a license, certificate or registration is required for the job for which you are applying – or if you wish to just submit
any certifications – please complete the below information.
Professional or Specialty License Type: License or Certification Number:
           
Expiration Date: State and/or Agency Granting License:
           

LANGUAGE PROFICIENCY
List language skills (other than English) that you have and your level of proficiency in each.
Language Level of Language Proficiency
      Spoken: High Written: High Read: High
Medium Medium Medium
Low Low Low
Additional Information:      
      Spoken: High Written: High Read: High
Medium Medium Medium
Low Low Low
Additional Information:      

Colorado Judicial Department Employment Application | Page 7 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa
MILITARY SERVICE DATA
Under the Colorado Constitution, art. XII, sec. 15, qualified veterans and surviving spouses are eligible for preference
consideration upon initial application review. If you are an honorably discharged veteran or unremarried surviving
spouse of a veteran who served on active duty in the United States Armed Forces during one of the periods for which
the federal government awards veteran’s preference points, you may receive points on an application review
examination for a position with the Colorado Judicial Department. You must attach a copy of a DD214 form and
other supportive documentation for veteran’s points to be awarded to your final score. If you are a current or
previous Colorado Judicial Department employee, you cannot claim veteran’s preference points unless you earned
veteran’s preference after becoming a Judicial Department employee.

Have you ever served on active duty in the U.S. Armed Forces? Yes No Veteran Vietnam Era
Veteran
Branch:       Dates of Service (Month, Year): From       To      
Primary Duties:      

EMPLOYMENT HISTORY
List jobs in reverse order, starting with your present or most recent job. Describe the positions you held to give a clear
picture of the duties you performed. List your entire employment history, including part-time, temporary, and
volunteer work. List each promotion as a separate job. For further employment, please add additional pages.
DO NOT SUBSTITUTE A RESUME IN LIEU OF THIS APPLICATION.
Employer: Job Title Dates of Employment (Month/Year):
Self Employed Breeder From 05/05 To current
Complete Address: 2610 S. 81st Lane Phoenix AZ 85043
Street/P.O. Box City State Zip Code
Employment Duties: Supervisor Title: Hours per Week:
 Handle accounts payable/receivable, data entry,       Varies
record keeping and filing, along with many other
Supervisor Name: Beginning Monthly Salary:
tasks and management skills
 Experience in sales, customer service and Lisa Hefley $      
answering phones, which is a large part of making Supervisor Email: Ending Monthly Salary:
the sale in breeding dogs
Lisa.c.potter@asu.ed
 Proficient in 10 key, Typing 60+ WPM, MS Word $      
u
Supervisor Telephone #: # of Employees You Supervised:
( 623 ) 225-4479      
Reason for Leaving:
I am completing my college degree and I would like to achieve my career goal of becoming a
probation officer.

Colorado Judicial Department Employment Application | Page 8 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa
Employer: Job Title Dates of Employment (Month/Year):
Bank One Merchant Teller From 11/99 To 04/01
Complete Address: 6030 N. 19th Avenue Phoenix Arizona 85015
Street/P.O. Box City State Zip Code
Employment Duties: Supervisor Title: Hours per Week:
 Cash Handling, Daily/Monthly Balancing Branch Assistant
40-48
 Customer Service, In person/On phone Manager
 Cross Selling Banking Products, Data Entry, 10 Supervisor Name: Beginning Monthly Salary:
Key Ceci Perez $ 800
Supervisor Email: Ending Monthly Salary:
none $ 1400
Supervisor Telephone #: # of Employees You Supervised:
( 602 ) 589-3513 0
Reason for Leaving:
Became a stay at home mom.

Employer: Job Title Dates of Employment (Month/Year):

Northern Point Apartments Book Keeper/Leasing Agent From 05/99 To 09/99
Complete Address: 1905W. Las Palmaritas Phoenix Arizona 85021
Street/P.O. Box City State Zip Code
Employment Duties: Supervisor Title: Hours per Week:
 Customer Service, Leasing Apartments, Handling Community Manager 40-45
tenant concerns and issues,
Supervisor Name: Beginning Monthly Salary:
 Cash Handling, Accepting rent, Daily and Monthly
Ledger Balancing, Data Entry Answering phones Stephanie $ 700
and getting potential residents into the office. Supervisor Email: Ending Monthly Salary:
none $ 700
Supervisor Telephone #: # of Employees You Supervised:
( 602 ) 995-7057 0
Reason for Leaving:
There was no position open after returning from maternity leave.

Colorado Judicial Department Employment Application | Page 9 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa
Employer: Job Title Dates of Employment (Month/Year):
Sam’s Club Cashier From 05/98 To 05/99
Complete Address: 8340 W. McDowell Phoenix Arizona 85307
Street/P.O. Box City State Zip Code
Employment Duties: Supervisor Title: Hours per Week:
 Cash Handling, Daily balancing Customer Service, Store Manager 40-50
Selling Sam’s Club Products
Supervisor Name: Beginning Monthly Salary:
Wayne Backus $ 550
Supervisor Email: Ending Monthly Salary:
none $ 680
Supervisor Telephone #: # of Employees You Supervised:
( 623 ) 936-8528 0
Reason for Leaving:
I left to get out of retain and enter more challenging office type work.

Employer: Job Title Dates of Employment (Month/Year):

            From       To      
Complete Address:                        
Street/P.O. Box City State Zip Code
Employment Duties: Supervisor Title: Hours per Week:
                 
Supervisor Name: Beginning Monthly Salary:
      $      
Supervisor Email: Ending Monthly Salary:
      $      
Supervisor Telephone #: # of Employees You Supervised:
(     )            
Reason for Leaving:
     

Colorado Judicial Department Employment Application | Page 10 of 15

 Colorado Judicial Department | Employment Application
Applicant’s Name (Last, First) | Hefley, Lisa

ADDITIONAL INFORMATION
List any other factors that make you particularly suited to the position for which you have applied and that
may be helpful to us in considering your application.

I am currently a senior at Arizona State University. I will be graduating with my

Bachelors Degree in Criminal Justice on May 12, 2011. I am a very quick learner in
anything I try. As a new graduate entering into the field, I am starting with a clean
slate. I haven’t learned any bad work habits and I can be taught to become the best
in my field.

APPLICATION CERTIFICATION and AUTHORIZATION

I certify that I possess the experience, education, and/or licenses required for the position I am applying for. I also
certify that all statements, information and documents provided with this application are true, complete and
correct to the best of my knowledge and are made in good faith. I understand any false statements, omissions, or
misrepresentations contained in this application or provided in the interview process or related correspondence
may disqualify me for employment consideration. Should an investigation at any time disclose any falsification,
omission, or misrepresentation as to the same, said disclosure may be grounds for immediate termination of
employment.
I hereby authorize and consent to the release of any and all information, including without limitation, all records,
statements and opinions held by any persons, employers, schools, law enforcement agencies, military personnel
and other authorized personnel to verify the information contained in this application. I authorize the release of
all records relating to my attendance at any school or educational institution, including without limitation,
transcripts and other documentation of academic or athletic achievements, attendance records, incident reports
and/or disciplinary actions. I authorize the release of any and all employment records, including without
limitation, my complete personnel file, applications for employment and any documentation of training, wages
paid, performance or evaluation, advancement, demotion or change in pay, any grievances filed by or against me,
and any corrective or disciplinary actions.
Please recheck application for accuracy before signing. Unsigned applications may be rejected.

Lisa C. Hefley 03/17/11

Signature Date
Please use ink or, if submitting electronically, please type your name.

Colorado Judicial Department Employment Application | Page 11 of 15

 Colorado Judicial Department
Affirmative Action Questionnaire

This information will be used for Federal Equal Employment Opportunity reporting purposes and to measure how
effective our recruitment efforts are in reaching all segments of the population. The information you give us is strictly
confidential. Submission of information is voluntary and refusal to supply it will not subject you to any adverse
treatment. Please give us your cooperation and check one answer under each question.
1. RACIAL OR ETHNIC CATEGORY
a. American Indian or Alaskan Native: All persons having origins in any of the original peoples of North
America and who maintain cultural identifications through tribal affiliation or community recognition.
b. Black or African-American (not of Hispanic origin): All persons having origins in any of the Black
racial groups of Africa.
c. White (not of Hispanic origin): All persons having origins in any of the original peoples of Europe, North
Africa or the Middle East.
d. Native Hawaiian or Pacific Islander: All persons having origins in any of the original peoples of the Far
East, Southeast Asia, the Indian Subcontinent, or Pacific Islands. This area includes, for example, China,
India, Japan, Korea, the Philippine Islands, and Samoa.
e. Hispanic or Latino: All persons of Mexican, Puerto Rican, Cuban, Central or South American or other
Spanish culture or origin, regardless of race.
f. Asian
g. Two or more races, not Hispanic or Latino:

2. SEX 5. EMPLOYMENT
a. Male a. Full-Time
b. Female b. Part-time or Temporary

3. DISABLED 6. AGE
a. Yes a. Under 40 years
b. No b. Over 40 years

4. MILITARY STATUS
a. Non-veteran
b. United States Veteran
PLEASE COMPLETE THE NEXT SECTION AND RETURN THE QUESTIONNAIRE, EVEN IF YOU
CHOOSE TO NOT ANSWER THE ABOVE QUESTIONS.

Name: Lisa C. Hefley

Position Title as Advertised: Court Judicial Assistant Position Number as Advertised: 21125

Lisa C. Hefley 03/17/2011

Signature Date
(Please use ink or, if submitting electronically, please type your name.)

TO BE COMPLETED BY LOCAL ADMINISTRATIVE AUTHORITY

                 

 Colorado Judicial Department | Employment Application
Class Code EEO Code (1 through 8) Judicial District # (Denver Probate – 24; Denver
Juvenile – 25; Denver Adult – 28;
Court of Appeals – 27; Supreme Court – 00;
SCAO – 29

Colorado Judicial Department Employment Application | Page 2 of 15

 Colorado Judicial Department
Americans with Disabilities Act
Citizen Complaint Procedure

The Colorado Judicial Department, as an Equal Opportunity Employer, complies with the provisions of the
Americans with Disabilities Act of 1990. Any person who believes that his/her rights under the Americans with
Disabilities Act have been violated and believes that he/she is aggrieved or adversely affected by an employee
of the Colorado Judicial Department, in the performance of the person’s job, may file a complaint against the
employee. The charges shall be in writing and include the name of the employee, the name of the court or
judicial office, and the specific details of the act or acts upon which the charges are based.

Complaints regarding violations of the Americans with Disabilities Act may be sent to:

Gerald A. Marroney
State Court Administrator
101 West Colfax, Suite 500
Denver, Colorado 80202

The State Court Administrator will refer the matter to the proper authority for investigation and appropriate
action.