<p class="cf-meta-value"><strong>Name</strong><br>Kathleen segure</p><p class="cf-meta-value"><strong>Email Address</strong><br>kathymontiquez@gmail.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>3479442668</p><p class="cf-meta-value"><strong>Street Address</strong><br>19 cumley st</p><p class="cf-meta-value"><strong>City</strong><br>Hamden</p><p class="cf-meta-value"><strong>Zip</strong><br>06514</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>03/18/1987</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>7</p><p class="cf-meta-value"><strong>Name of Court</strong><br>New haven </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>Johnny segure</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>Camie alcide</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>516-859-1166</p>