Butterfly House Outreach Form

Please complete the form below to request an outreach program at the Butterfly House.

This form is for registration for outreach programs. If you wish to schedule a self-guided tour, call (314) 577-0888 x 2 to reserve your date. If you wish to schedule an instructor-led program at the Butterfly House, click here for more information.

First Name:*

Last Name:*

Email Address:*

Telephone:*

Please enter the name of your school or organization.

School/Group Name:*

Address :*

Please enter the name of your school's district. You may also enter 'private', 'parochial' or 'charter'.

School District:*

Please enter the grade level(s) of students who will be attending this field trip.

Grade Level(s)/Age Range:*

In the space below, please list the names of all other teachers whose classes we will visit on this outreach.

Example:	Jane Smith, jsmith@ourschool.edu John Doe, jdoe@ourschool.edu

Example: Jane Doe, jdoe@ourschool.edu John Smith, jsmith@ourschool.edu

Additional Teachers:

Select the Outreach Program you wish to schedule:

Outreach Programs:
Story of a Butterfly (preK-K)
Wings of Wonder (K-2)
Adventures in a Butterfly Garden (K-3)
Bug Lab (3-5)
Bugs Alive: Ecosystem Challenge (3-5)

Adult Group Programs:
Backyard Scientist
Bee Friendly
Beneficial Bugs
Growing a Pollinator Garden
Insect Hotels
Meet the Pollinators
Monarchs and Friends
Putting Your Butterfly Garden to Bed
Right Plant, Right Place
Waking Up Your Butterfly Garden

Science Nights:
Family Science Night
STEAM Night

Standard programs last for 45 minutes and can accommodate up to 30 students. If you need to schedule for more than 30 students, please schedule additional programs on the same day.

Number of Students:*

Please enter your intended arrival time.

Start Time:*

Please enter your intended departure time.

End Time:*

Please enter three possible dates for your visit, in order of preference.

Please enter your preferred date for your visit with us.

First Choice:*

Second Choice:*

Please enter a third possible date for your visit.

Third Choice:*

Please let us know how you learned about our outreach program.

How did you hear about us?:

Please enter any additional information/special requests

Comments/Requests:

Please take a moment and review what you have entered to ensure that all information is correct. Then click 'Submit' to submit your request to School Programs!

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Butterfly House Outreach Form