<p class="cf-meta-value"><strong>Telephone</strong><br>7579200415</p><p class="cf-meta-value"><strong>Street Address</strong><br>1210 Clarence St</p><p class="cf-meta-value"><strong>City</strong><br>Norfolk</p><p class="cf-meta-value"><strong>State</strong><br>VA</p><p class="cf-meta-value"><strong>Zip</strong><br>23502</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>09/24/1981</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>15</p><p class="cf-meta-value"><strong>Name of Court</strong><br>New Britain</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>Sarah DeLaura</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>Karen Perreault</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>757-364-9110</p>