| Application-ID | SHDHS-M2023-05-Lipchik-2425 |
|---|---|
| School Year | 2425 |
| Reviewed | No |
| Attending | Yes |
| Primary Parent/ Guardian Information | |
| Primary Parent/ Guardian Name | Amanda Lipchik |
| Primary Parent / Guardian Email | Email hidden; Javascript is required. |
| Primary Parent / Guardian Phone | (859) 446-9264 |
| Primary Parent / Guardian Address | 985 Stewart Lane Sparta, Kentucky 41086 Map It |
| Primary Parent/ Guardian Employer | Amazon.com |
| Primary Parent/ Guardian Occupation | Program Manager |
| Primary Parent/ Guardian Highest Education Level | College Graduate |
| Primary Parent/ Guardian Marital Status | Divorced |
| Primary Parent/ Guardian Relationship to Student | Parent (Mother) |
| Primary Parent / Guardian Legal Custody (yes/no) | Yes |
| Are you a Saint Henry District High School alumni? | No |
| Family Religion | Other |
| Family Parish Membership | No-Catholic |
| Second Parent/ Guardian Information | |
| Second Parent/ Legal Guardian Address | Kentucky Map It |
| Student(s) Information Section | |
| Student 1 Legal Name | Cayden Alexander Lipchik |
| Student 1 - Grade Entering | 9 |
| Student 1 Student Social Security | 698-14-6203 |
| Student 1 Gender | Male |
| Student 1 Birth Date | 06/20/2010 |
| Student 1 Birth Country | United States |
| Student 1 Race | White or Caucasian |
| Student Ethnicity | Non-Hispanic/Latino |
| Student 1 Birth State | Virginia |
| Student 1 County of Residence | Owen County (KY) |
| Student 1 Lives Primary Parent /Guardian (yes/no) | Yes |
| Student 1 School is currently attending or attended | Other |
| Student 1 School is currently attending or attended (other) | Home School |
| Student 1 School Principal Name | Amanda Lipchik |
| Student 1 Principal's Email | Email hidden; Javascript is required. |
| Athletic Information | |
| Did the student(s) play a sport at your previous school? | No |
| Emergency Information | |
| First Emergency Contact Name | Deborah Story |
| First Emergency Contact Relationship | Grandmother |
| First Emergency Contact Phone | (859) 630-4873 |
