Order Form- Europe
Order your butterflies and licenses here
Your Information
School, Organization or group name
*
What type of school?
*
School
Community organization
Religious organization
Club or social group
Family
Other
Your name
*
First Name
Last Name
Your email address
*
example@example.com
Will you be the facilitator of The Butterfly Project?
*
Yes, I will be the facilitator
No, someone else will be the facilitator
Facilitator's name
*
First Name
Last Name
Facilitator's email address
*
example@example.com
Is this your site's first time participating in The Butterfly Project?
*
Yes
No
I do not know
How did you learn about The Butterfly Project?
*
Colleague
Internet search
Social media
Friend or family member
Student or student's family
Professional development seminar
Associate organization (ie- museum, ADL, another nonprofit, etc)
Community event
Film screening of "NOT The Last Butterfly"
Other
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Your Programming
When will your program take place?
*
-
Month
-
Day
Year
Date
What educational components are you planning to include with your participation in The Butterfly Project?
*
Is your site a school?
*
Yes
No
Which grades will be participating in The Butterfly Project?
*
Preschool
7th grade
Kindergarten
8th grade
1st grade
9th grade
2nd grade
10th grade
3rd grade
11th grade
4th grade
12th grade
5th grade
University
6th grade
What are the ages of your participants?
*
3-9 years old
25-39 years old
10-13 years old
40-54 years old
14-18 years old
55+
19-24 years old
Why have you chosen to join The Butterfly Project?
*
Has your school or community experienced any antisemitism, Holocaust distortion/denial, racism, discrimination, or bullying issues?
*
Yes
No
I'm not sure
Please describe the antisemitism, Holocaust distortion/denial, racism, discrimination, or bullying issues experienced at your school or community.
*
Please provide any pertinent information about your programming that you'd like to share with us.
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Your Order
Please make your selections below:
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Classroom Butterfly Kit
$
90.00
Domestic shipping within Germany is included
Quantity
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Item subtotal:
$
0.00
Participation Lifetime License
$
75.00
This is a one-time licensing fee for lifetime participation in The Butterfly Project. It is applicable to first orders only.
Film Package Screening Rights Lifetime License
$
180.00
This license provides your school or organization with unlimited screenings rights to our film package.
Credit Card Details
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Last Name
Credit Card Number
Security Code
Card Expiration
Shipping Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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