Butterfly House

Outreach Program Request Form

Please complete this form to request an Outreach Program from the Butterfly House. Outreach programs bring hands-on, invertebrate focused learning directly to your school or site.

A member of the Butterfly House Education team will follow up to confirm details, scheduling, and pricing.

Session Information

Standard Outreach Programs run 45 minutes each and can accommodate up to 30 students and their teachers.
Up to three programs may be scheduled during a single visit.
Please plan to provide a 10-minute break between program sessions.

Additional outreach offerings are available (i.e. activity tables at science nights, custom presentations for adult groups, etc.)

Group Information

Name of School or Organization*

First Name*

Last Name*

Address Line 1*

Address Line 2

City*

State*

ZIP*

Phone*

Email Address

Enter your email address*
0 of 100

Day of Contact

Name, email, and phone number.*
0 of 100

Program Details

Outreach Programs for Students

Requested Outreach Program

Grade Level(s)

0 of 100

Number of Students

0 of 100

Speakers for Adult Groups

Select a speaker topic

Who is the audience?

# of attendees, purpose, etc.
0 of 100

Science Nights

Type of Event
Family Science Night

STEAM Night

Who will be at the event?

est. # of attendees, ages, etc.
0 of 100

Scout Outreach

Tell us more:

What type of outreach?
0 of 100

Where will the program take place within your site?
0 of 250

How many sessions (classes/groups) would you like to schedule?
0 of 250

Scheduling Preferences

Requested Date*

Alternate Date

Requested Arrival Time (9 AM or later)*

Additional Information

Are there any special needs and/or additional information that you'd like us to be aware of?
0 of 250

$
50.00

$
50.00

Discount

-
$
50.00

Table/Electric
$
50.00

Package 1: 2 Tables & 1 Electrical Circuit
$
50.00

Sub Total
$
50.00

Cover Cost
$
50.00

$
50.00

Please review the required fields above.

Required fields are either missing or did not meet the validation requirements.

Please review the payment information below.

First Name*

Last Name*

Email Address*

Please review the required fields above.

Required fields are either missing or did not meet the validation requirements.

Please review the required fields above.

Required fields are either missing or did not meet the validation requirements.

First Name*

Last Name*

Email Address*

Please allow up to 5 business days for a response from our team. Outreach programs are scheduled based on educator availability and should be requested at least 4 weeks in advance.

For questions or additional information, please contact the Butterfly House Education team at butterflyhouseeducation@mobot.org.

Butterfly House

Outreach Program Request Form

Thank You

Thank You