<p class="cf-meta-value"><strong>Telephone</strong><br>9143910442</p><p class="cf-meta-value"><strong>Street Address</strong><br>33 Strawberry Patch Lane</p><p class="cf-meta-value"><strong>City</strong><br>Stamford</p><p class="cf-meta-value"><strong>Zip</strong><br>06902</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>08/12/1986</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>3 and 6</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Stamford Court House</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>Alexander Krupp</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>Barbara Hallen</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>914-391-6608</p>