Bartn Orchards

Employment Application

Barton Entertainment L.L.C.

63 Apple Tree Lane

Poughquag, NY 12570

Full Name:_______________________________________                                   Date:____ / ____ / ____

Social Security#:___ ___ ___ - ___ ___ - ___ ___  ___ ___

Address:_______________________________  City:________________________ State:_____ Zip:_______

Phone:_________________  Cell/Pager/Other:________________________ Email:_____________________

If under 18 state age:_____  (Minors must obtain required work/age certificates)

Have you been convicted of a felony in the past 5 years?    YES*_____    NO_____

*If YES, please provide details of conviction, nature of offense, and rehabilitation:

__________________________________________________________________________________________

__________________________________________________________________________________________

Day time position applying for:        ___________________________________________________________

How did you hear about us?:            ___________________________________________________________

If referred, by whom?:                     ___________________________________________________________

Have you worked for us in the past? (If so what position):  ________________________________________

Do you have friends or relatives that have worked for us? (If so Names/Dates/Positions):

__________________________________________________________________________________________

Do you have any past experience in retail sales/entertainment venues/direct marketing that would apply to this business?:______________________________________________________________________________

Do you have any experience with animals? (In particular horses and ponies):__________________________

Reference Name:_________________________________  Phone:___________________________________

Address:_______________________________  City:________________________ State:_____ Zip:________