<p class="cf-meta-value"><strong>Telephone</strong><br>2032603754</p><p class="cf-meta-value"><strong>Street address</strong><br>27 Nelson Terrace </p><p class="cf-meta-value"><strong>City</strong><br>Bridgeport </p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06610</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>02/21/1990</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>6</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Bridgeport Superior Court </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>Jessica Marin </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>Is there any history of violence or abuse within the family?</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>Mayra Gonzalez </p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>+1 (203) 583-0273</p>