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CSM Teacher Workshop
Butterfly Pavilion Course Application Form
Registration is not complete and a place in the workshop is not reserved until the registration fee has been received. Please read
the Registration, Tuition and Refund Policy below for details. To register, complete and mail for fax this form with payment (credit
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card or check) to the Butterfly Pavilion, c/o Adult Programs, 6252 W. 104 Ave., Westminster, CO 80020, Fax: 303-657-5944. You
must pre-register at least 48 hours prior to the start of a workshop (Saturday and Sunday excluded).
If you have questions please contact education@butterflies.org or 720-974-1862.
Contact Information E-mail:
Name: Phone:
Home Address: City, State, Zip:
School: Gender: Male or Female
Grade Level(s) that you Teach: Date of Birth:
Workshop Information
Class Selection: Please place a check by your selection(s). Full descriptions of each workshop can be found on the Butterfly Pavilion
website: http://www.butterflies.org/education/teacher-educator-workshops.php
CSM course number: CT -
ART AND SCIENCE SERIES
Gourd Baskets and Pollinators
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Tuesday, June 19
8:00 am – 12:00 pm
Papermaking and Paper Wasps $45
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Tuesday, June 19
1:00 pm – 4:00 pm
Scientific Illustration and Plants
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Tuesday, June 26
8:00 am – 12:00 pm
Printmaking and Aquatic Invertebrates $45
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Tuesday, June 26
1:00 pm – 4:00 pm
Batik and Insects
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Sunday, September 30
8:00 am – 12:00 pm
Dreamcatchers and Spiders
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Sunday, September 30
1:00 pm – 5:00 pm $45
Art and Science per person Supply Fee $10
WORKSHOPS
Friends or Foes
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Thursday, June 14 $45
8:00 am– 5:00 pm
Insects in Art and Culture
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Wednesday - Thursday, June 20 and 21 $90
8:00 am– 5:00 pm $10 supply fee
Dreamweaver
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Wednesday, June 27 $45
8:00 am– 5:00 pm
Who Swallowed a Fly?
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Thursday, June 28 $45
8:00 am– 5:00 pm
Secrets of the Rainforest – From Morphos to Malachites
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Tuesday, July 17 $45
8:00 am– 5:00 pm
Insect Investigations: Science Notebooks and Bugs in the Classroom
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Wednesday, July 18 $45
8:00 am– 5:00 pm
Project Learning Tree: Forests of the World
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Tuesday, July 24 $30 half day
8:00 am– 5:00 pm $45 full day
Project WILD: Growing up WILD
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Thursday, July 26 $45
8:00 am– 5:00 pm
………………………………………………………………………………………………………………………………………………………………………………….
Subtotal
Please check any of these that apply:
Butterfly Pavilion Member
G.R.O.W. Program Teacher
TOTAL (If you checked one of the boxes above, we will calculate your discount and total)
Payment Information
I will pay the Registration Fee by:
Check (please enclose with form), check number:
Credit Card: Complete credit card information below.
Type of credit card: American Express Discover MasterCard Visa Discover
Card number:
Expiration Date:
Amount to Charge
(registration fee only):
Registration, Tuition and Refund Policies:
The registration fee includes the cost of workshop materials, admission to the Butterfly Pavilion, instructor fees and room usage. We ask that you pre-register at least
48 hours prior to the start of a workshop (Saturday and Sunday excluded). The registration form must be accompanied by the registration fee payment by check or
credit card authorization. Registration is not complete and a place in the workshop is not reserved for you until the registration fee has been received. If you have not
received confirmation a week prior to the workshop, please call the Butterfly Pavilion.
The tuition fee is the cost of taking the workshop for recertification credit through the Colorado School of Mines. You will receive a CSM Course Credit Form with
your registration materials. You must pay the tuition fee during the workshop with a separate check, payable to "CSM Continuing Education.” This fee goes directly
to the CSM. Note that you do not have to take the workshop for credit.
If a course registrant cancels or transfers an enrollment, the registration fee minus a $25 cancellation/ transfer fee will be refunded or applied to another Butterfly
Pavilion course. Unless otherwise indicated, you must cancel at least 48 hours in advance of a workshop to qualify for a refund (Saturday and Sunday excluded). Once
a class has begun, no full or partial tuition refunds will be granted. The Butterfly Pavilion reserves the right to cancel a course (usually one week prior to delivery) if
the minimum enrollment is not reached (with full registration fee refunded to registrants). The Butterfly Pavilion, Colorado School of Mines and the Teacher
Enhancement Office will not be liable for any other expenses incurred by registrants.
