<p class="cf-meta-value"><strong>Name</strong><br>Keenan DeLand</p><p class="cf-meta-value"><strong>Email Address</strong><br>DELANDK27@GMAIL.COM</p><p class="cf-meta-value"><strong>Telephone</strong><br>2038361174</p><p class="cf-meta-value"><strong>Street address</strong><br>2 Chaucer Drive</p><p class="cf-meta-value"><strong>City</strong><br>SHELTON</p><p class="cf-meta-value"><strong>State</strong><br>Connecticut</p><p class="cf-meta-value"><strong>Zip</strong><br>06484</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>07/06/1986</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>8, 4</p><p class="cf-meta-value"><strong>Court District Your Case Is In</strong><br>Milford</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>Milissa</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>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>Richard DeLand</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>2038361174</p>