| Application-ID | SHDHS-bebca- |
|---|---|
| School Year | 2425 |
| Reviewed | No |
| Attending | Yes |
| Primary Parent/ Guardian Information | |
| Primary Parent/ Guardian Name | Savannah Jackson |
| Primary Parent / Guardian Email | Email hidden; Javascript is required. |
| Primary Parent / Guardian Phone | (859) 446-3569 |
| Primary Parent / Guardian Address | 514 Erlanger Rd Erlanger, Kentucky 41018 Map It |
| Primary Parent/ Guardian Employer | TLC Learning Center |
| Primary Parent/ Guardian Business Phone | (859) 360-2893 |
| Primary Parent/ Guardian Occupation | Owner/Director |
| Primary Parent/ Guardian Highest Education Level | College Graduate |
| Primary Parent/ Guardian Marital Status | Married |
| 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 | NON Catholic |
| Family Parish Membership | No-Catholic |
| Second Parent/ Guardian Information | |
| Second Parent/ Legal Guardian Name | Imer Viveros |
| Second Parent/ Legal Guardian Email | Email hidden; Javascript is required. |
| Second Parent/ Legal Guardian Primary Phone | (859) 992-4151 |
| Second Parent/ Legal Guardian Address | Kentucky Map It |
| Second Parent/ Legal Guardian Relationship to Student | Parent (Father) |
| Second Parent/ Legal Guardian Marital Status | Married |
| Second Parent/ Legal Guardian Legal Custody (yes/no) | Yes |
| Second Parent/ Legal Guardian - Lives with Student (yes/no) | Yes |
| Is Second Parent a Saint Henry District High School alumni? | No |
| Student(s) Information Section | |
| Student 1 Legal Name | Imer Ivan Viveros |
| Student 1 Preferred Name | Ivan |
| Student 1 - Grade Entering | 9 |
| Student 1 Student Social Security | 406-71-0217 |
| Student 1 Gender | Male |
| Student 1 Birth Date | 11/27/2009 |
| Student 1 Birth Country | United States |
| Student 1 Race | White or Caucasian |
| Student Ethnicity | Hispanic or Latino |
| Student 1 Birth State | Kentucky |
| Student 1 Birth County | Kenton |
| Student 1 County of Residence | Kenton 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) | Tichenor Middle School |
| Student 1 School Principal Name | Mr. Cooley |
| Student 1 Principal's Email | Email hidden; Javascript is required. |
| Student 1 School Phone Number | 8597272255 |
| Athletic Information | |
| Did the student(s) play a sport at your previous school? | Yes |
| Emergency Information | |
| First Emergency Contact Name | Delores Jackson |
| First Emergency Contact Relationship | Grandma |
| First Emergency Contact Phone | (859) 999-4351 |
| First Emergency Contact Email | Email hidden; Javascript is required. |
