Student Mentor Program Application Form Private Tutoring Program for Beginners Application Date Applicant's Details Contact Name Phone Cell Address, City, State & Zip AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingDistrict of Columbia Your Email Website Butterfly Raising Experience Have you ever raised butterflies? —Please choose an option—YesNo If yes, how many years? If no, skip to 'Host Plants'. —Please choose an option—12345678910+ If yes, in what capacity? Check all that apply. HobbyCommerciallyEducationExhibitOther If other, please specify Which Species? How many per month? Explain your rearing space and location. What is your rearing method? (pop-ups/totes/free ranging/other) Explain any problems/challenges you have encountered. Host Plants Do you currently have host plants available? —Please choose an option—YesNo If yes, list which species. More About You Explain why you should be considered for the Student Mentor Program. What do you hope to gain from being in the program? Have you taken any courses offered through AFB? If yes, please list the course title(s). How long have you been a member of AFB? Do you have current or previous memberships in any other butterfly trade organizations or groups? If yes, please list name(s) and type of organization(s) and dates of membership. Will you be obtaining your own livestock? —Please choose an option—YesNo If yes, which species? Where do you intend to locate the species you will rear? When will you begin your season? Will you be utilizing the Painted Lady option? (Prior to shipping you will receive an invoice for the shipping cost, payable by Credit Card or PayPal only) —Please choose an option—YesNo Date you want the caterpillars to arrive: note-Caterpillars need a minimum 4 week lead time. Dates available for selection are adjusted accordingly. Once your application has been submitted, you will receive a notice of acceptance or denial within one week from submission. Guidelines for Mentoring Although your mentor is eager to help you, (s)he has limited time, is a full time farmer, and very busy. Please be respectful of their time and willingness to answer questions. Please keep contact to a minimum of three times a week. Your mentor will inform you if they prefer to be contacted via phone or email. Make a list of questions to be asked and submit at those three times. Misuse of this privilege will be reason remove you from the mentoring/student program. I have read over the guidelines and agree to them.