<p class="cf-meta-value"><strong>Name</strong><br>Nyle Blanck</p><p class="cf-meta-value"><strong>Email Address</strong><br>nyle.blanck@gmail.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>2036426777</p><p class="cf-meta-value"><strong>Street address</strong><br>31 Clinton Street</p><p class="cf-meta-value"><strong>City</strong><br>Milford</p><p class="cf-meta-value"><strong>State</strong><br>Connecticut</p><p class="cf-meta-value"><strong>Zip</strong><br>06460</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>06/21/1991</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>2</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Ansonia-Milford Judicial Distric</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>Lauren Blanck</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>Alyson Blanck</p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>2036193121</p>