<p class="cf-meta-value"><strong>Telephone</strong><br>203-243-0547</p><p class="cf-meta-value"><strong>Street address</strong><br>83 Henry Avenue</p><p class="cf-meta-value"><strong>City</strong><br>Stratford</p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06614</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>01/13/1976</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>14 and 19</p><p class="cf-meta-value"><strong>Name of Court</strong><br>State of Connecticut Judicial Branch</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>Damion Henry</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>Yes</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>Judith Thomas</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>203-997-8600</p>