<p class="cf-meta-value"><strong>Name</strong><br>Heather Wilson</p><p class="cf-meta-value"><strong>Email Address</strong><br>autumnxchill@gmail.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>480-209-6878</p><p class="cf-meta-value"><strong>Street address</strong><br>394 Hawthorne Ave Unit A</p><p class="cf-meta-value"><strong>City</strong><br>Derby</p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06418</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>12/07/1983</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>11,8</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Unknown</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>Austin Wilson</p><p class="cf-meta-value"><strong>Do you wish to participate in the program with the other parent?</strong><br>Yes, 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>Austin Wilson</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>6024025409</p>