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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 for "First Name"

Last Name*

Answer required for "Last Name"

Email*

Answer required for "Email"

Phone*

Number Required

Your relationship to the student*

Answer required for "Your relationship to the student"

Student Information

Student's First Name*

Answer required for "Student's First Name"

Student's Middle Name

Answer required for "Student's Middle Name"

Student's Last Name*

Answer required for "Student's Last Name"

Student's Date of Birth

Answer required for "Student's Date of Birth"

Is the student currently enrolled at Bricolage Academy?*

Answer required for "Is the student currently enrolled at Bricolage Academy?"

Yes

Upload any necessary documentation.

Answer required for "Upload any necessary documentation."

Choose a file or drag it here.

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"