<p class="cf-meta-value"><strong>Name</strong><br>Thomas Banks</p><p class="cf-meta-value"><strong>Email Address</strong><br>thomasbanks187@yahoo.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>2036283082</p><p class="cf-meta-value"><strong>Street Address</strong><br>23 N Main St Apt 3F </p><p class="cf-meta-value"><strong>City</strong><br>Norwalk</p><p class="cf-meta-value"><strong>Zip</strong><br>06854</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>10-31-1980</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>Bridgeport </p><p class="cf-meta-value"><strong>Do you have a fee waiver?</strong><br>Yes</p><p class="cf-meta-value"><strong>Other Parent Name</strong><br>Josina Thomas </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>Josina Thomas</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>9148884545</p>