<p class="cf-meta-value"><strong>Telephone</strong><br>2035704977</p><p class="cf-meta-value"><strong>Street Address</strong><br>71 Strawberry Hill ave, apt 616</p><p class="cf-meta-value"><strong>City</strong><br>Stamford </p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06902</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>07/29/1979</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>3</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Stamford </p><p class="cf-meta-value"><strong>Do you have a fee waiver?</strong><br>No</p><p class="cf-meta-value"><strong>Other Parent Name</strong><br>Hessel Pole</p><p class="cf-meta-value"><strong>Do you wish to participate in the program with the other parent?</strong><br>No</p><p class="cf-meta-value"><strong>Does the participant speak English?</strong><br>Yes</p><p class="cf-meta-value"><strong>Is the participant hearing impaired?</strong><br>No</p><p class="cf-meta-value"><strong>Emergency Contact Name</strong><br>Adriana Sbardelotto</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>1 (203) 912-3530</p>