<p class="cf-meta-value"><strong>Name</strong><br>Summer Mohamed </p><p class="cf-meta-value"><strong>Email Address</strong><br>summer@divinellc.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>8622814597</p><p class="cf-meta-value"><strong>Street address</strong><br>31 Andrasko Road</p><p class="cf-meta-value"><strong>City</strong><br>Beacon Falls </p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06403</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>03/05/1988</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>6, 4, 3 </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>Yes</p><p class="cf-meta-value"><strong>Other Parent Name</strong><br>Gassem Ahmed</p><p class="cf-meta-value"><strong>Do you wish to participate in the program with the other parent?</strong><br>Yes</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>Abdu Mohamed </p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>9736261831</p>