<p class="cf-meta-value"><strong>Telephone</strong><br>3473565705</p><p class="cf-meta-value"><strong>Street Address</strong><br>19 Madison ave </p><p class="cf-meta-value"><strong>City</strong><br>Waterbury </p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06706</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>08/30/1988</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>8</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Waterbury 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>Obrian James</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>Suzette Duncan-Henry</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>(917) 564-5447</p>