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Student Records Request

Please complete the form below. Required fields marked with an asterisk *

Contact Information of the Individual Making the Request

First Name*

Answer Required

Last Name*

Answer Required

Email*

Answer Required

Phone*

Number Required

Your relationship to the student*

Answer Required

Student Information

Student's First Name*

Answer Required

Student's Middle Name

Answer Required

Student's Last Name*

Answer Required

Student's Date of Birth

Answer Required

Is the student currently enrolled at Bricolage Academy?*

Answer Required

Yes

Upload any necessary documentation.

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Choose a file or drag it here.

Confirmation Email

Confirmation Email *

Email Required