<p class="cf-meta-value"><strong>Name</strong><br>Kelly Gervolino</p><p class="cf-meta-value"><strong>Email Address</strong><br>kellygervolino@gmail.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>203-451-8121</p><p class="cf-meta-value"><strong>Street Address</strong><br>4231 Avalon Drive East</p><p class="cf-meta-value"><strong>City</strong><br>New Canaan</p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06840</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>02/01/1975</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>15,16</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Stamford Judicial District</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>Douglas Gervolino</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>Erica D'Urso</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>203-979-1485</p>