<p class="cf-meta-value"><strong>Name</strong><br>Nicole Bruns</p><p class="cf-meta-value"><strong>Email Address</strong><br>nikkimjb84@yahoo.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>4016441193</p><p class="cf-meta-value"><strong>Street address</strong><br>28 Pinecrest Lane</p><p class="cf-meta-value"><strong>City</strong><br>Baltic</p><p class="cf-meta-value"><strong>State</strong><br>CT</p><p class="cf-meta-value"><strong>Zip</strong><br>06330</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>02/03/1984</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>10,17</p><p class="cf-meta-value"><strong>Name of Court</strong><br>Norwich Superior Court </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>Joshua Bruns</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>Mike Gaudreau </p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>5083082268</p>