Questions
Personal Information
Talents:
Voice: | Baritone |
Tell us about your interests/talents and how long you have been pursuing. Provide several. | Baseball, Swimming, Japanese Flute |
Favorite:
Color | Blue |
Food | Vegetables |
Music | Ellie Goulding |
Animal | Cats |
Pet | Cats |
Car | Nissan |
Movie | Your Name |
Song | Love Me Like You Do |
Goals:
Academic | Publication of many great journals |
Professional | Become a successful pharmaceutical researcher |
Personal | Making a great contribution to society and people |
Religion:
Faith | Other |
Denomination | Shinto |
Languages:
Speak | Japanese, English |
Sports:
Play | Baseball |
Watch | Baseball, Football, Basketball |
Siblings:
Are you or any of your siblings twins? Please specify who and if they are fraternal or identical | No |
Academics
Standard Test Score: provide score or denote N/A if not taken
SAT on scale of | N/A - N/A |
ACT on scale of | N/A - N/A |
GRE on scale of | N/A - N/A |
MCAT on scale of | N/A - N/A |
LSAT on scale of | N/A - N/A |
GMAT on scale of | N/A - N/A |
TOEFL on scale of | N/A - N/A |
Other on scale of | N/A - N/A |
High School
Question | Response | on scale of |
GPA on scale of | 3.25 | 4.0 |
College
Question | Response | on scale of |
GPA on scale of | 2.725 | 4.0 |
Graduate School
Question | Response | on scale of |
GPA on scale of | 3.33 | 4.0 |
Subjects Studied:
Major subjects | Pharmaceutical Sciences |
Minor subjects | Genetics |
Degrees
Bachelor's | Pharmaceutical Sciences |
Master's | Pharmaceutical Sciences |
Doctorate | Pharmaceutical Sciences |
Other(s) | N/A |
Awards & Activities
High school | Rugby |
College | A cappella, international exchange |
Academic | Biochemical experiments |
Professional | Pharmaceutical research |
Political | N/A |
Personal | N/A |
Charitable | N/A |
Others | N/A |
Military
Served in military | No |
Branch | N/A |
Rank | N/A |
Years of service | N/A |
Physical Features
Hands | Right-Handed |
Fingers | Medium |
Sizes & Measurements
Neck (inches) | 14 |
Chest (inches) | 38 |
Inseam (inches) | 35 |
Waist (inches) | 30 |
Sleeve (inches) | 32 |
Hat size | 7 ΒΌ |
Shoe size | 10 |
Physical Aids
Eyes:
Vision | Near-Sighted |
Glasses | Single - -6.5/-6.5 |
Astigmatism | No |
Age started wearing glasses/contacts | 13 |
Laser surgery? | No |
Dental:
Device | Braces |
Reason | Cosmetic |
Age range during use | 11-17 |
Other Physical Aids:
List | N/A |
Reason/cause | N/A |
Facial Features
Eyes:
Set |
|
Size |
|
Shape |
|
Color |
|
Shade |
|
Eyebrows:
Arch |
|
Thickness |
|
Set |
|
Nose:
Size |
|
Shape |
|
Width |
|
Length |
|
Bridge |
|
Nostril flare |
|
Cheekbones:
Set |
|
Mouth:
Size |
|
Lips |
|
Turn |
|
Teeth:
Size |
|
Set |
|
Gap | No |
Condition |
|
Chin:
Shape |
|
Prominence |
|
Cleft |
|
Ears:
Size |
|
Set |
|
Angle |
|
Lobe size |
|
Lobe attachment |
|
Hair:
Color at birth |
|
Natural color in adulthood |
|
Shade |
|
Type |
|
Fullness |
|
Texture |
|
Skin:
Tone More about skin tones |
|
Tan ability |
|
Condition |
|
Hairline:
Forehead |
|
Contour |
|
Other Facial Features:
Moles |
|
Freckles |
|
Dimples |
|
Adam's apple |
|
Facial Hair
Thickness |
|
Color |
|
Shade |
|
Family Information
Donor's Parents
Donor's Father Personal Information
Occupation | System engineer |
Donor's Father Education:
Level | College |
Degree | Bachelor |
Subject | Technology |
Donor's Father Religion:
Faith | Other |
Denomination | Shinto |
Donor's Father Languages:
Speak | Japanese |
Donor's Father Talents:
Voice | Baritone |
Instrument | Guitar |
Other | N/A |
Donor's Father Physical Information
Body
Age | 62 |
Height | 5'6" |
Weight | 132 lbs. |
Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
Eye Color | Brown |
Eye shade | Medium |
Corrective Lenses | No |
Hair:
Original hair color | Black |
Type | Straight |
Skin:
Skin Tone More about skin tones | Porcelain |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial Dimples | Deep |
Donor's Mother Personal Information
Occupation | Aluminum Designer |
Donor's Mother Education:
Level | College |
Degree | Bachelor |
Subject | Computer |
Donor's Mother Religion:
Faith | Other |
Denomination | Shinto |
Donor's Mother Languages:
Speak | Japanese |
Donor's Mother Talents:
Voice | Soprano |
Instrument | Piano, Flute |
Other | N/A |
Donor's Mother Physical Information
Body
Age | 55 |
Height | 5'3" |
Weight | 110 lbs. |
Hands | Right-Handed |
Facial Features
Eyes:
Eye Color | Brown |
Eye shade | Dark |
Corrective Lenses | Yes |
Hair:
Original hair color | Black |
Type | Straight |
Skin:
Skin Tone More about skin tones | Ivory |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial Dimples | Deep |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
Full/Half sibling | Full |
Sibling #1 Physical Information
Body
Age | 35 |
Height | 5'5" |
Weight | 119 lbs. |
Hands | Right-Handed |
Sibling #1 Personal Information
Occupation | Librarian |
Education:
Level | College |
Degree | Bachelor |
Subject | History |
Languages:
Speak | Japanese |
Talents:
Voice | Alto |
Instrument | Piano |
Other | N/A |
Sibling #1 Children:
# Boys Ages: | 1 - 0 |
# Girls Ages: | 0 |
Sibling #1 Facial Features
Eyes:
Eye color | Brown |
Eye shade | Dark |
Corrective Lenses | Yes |
Hair:
Original hair color | Black |
Type | Straight |
Skin:
Skin tone More about skin tones | Porcelain |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial dimples | Deep |
Donor's Sibling #2
Full/Half sibling | Full |
Sibling #2 Physical Information
Body
Age | 27 |
Height | 5'5" |
Weight | 110 lbs. |
Hands | Right-Handed |
Sibling #2 Personal Information
Occupation | Helper |
Education:
Level | College |
Degree | Bachelor |
Subject | Nursing |
Languages:
Speak | Japanese |
Talents:
Voice | Alto |
Instrument | Piano |
Other | N/A |
Sibling #2 Children:
# Boys Ages: | 1 - 0 |
# Girls Ages: | 0 |
Sibling #2 Facial Features
Eyes:
Eye color | Brown |
Eye shade | Dark |
Corrective Lenses | No |
Hair:
Original hair color | Black |
Type | Straight |
Skin:
Skin tone More about skin tones | Ivory |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial dimples | Deep |
Father's Siblings
Father's Sisters
# of Sisters | 1 |
Ages of Sisters: | 52 |
Education levels for each: | College |
Occupations for each: | Accountant |
Father's Sisters' Total Children:
# Boys | 2 |
# Girls | 1 |
Mother's Siblings
Mother's Brothers
# Brothers | 1 |
Ages of Brothers: | 52 |
Education levels for each: | College |
Occupations for each: | Elementary School Teacher |
Mother's Brothers' Total Children:
# Boys | N/A |
# Girls | 1 |
Mother's Sisters
# Sisters | 1 |
Ages of Sisters: | 57 |
Education levels for each: | College |
Occupations for each: | Childcare Professional |
Mother's Sisters' Total Children:
# Boys | N/A |
# Girls | 1 |
Father's Parents
Father's Father
Education
Level | Some High school |
Degree | Not Completed |
Occupation: | Train driver |
Siblings:
# Brothers | 6 |
# Sisters | 6 |
Other:
Languages | Japanese |
Religion | Other |
Father's Mother
Education
Level | Some High school |
Degree | Not Completed |
Occupation: | Grocery store staff |
Siblings:
# Brothers | 0 |
# Sisters | 2 |
Other:
Languages | Japanese |
Religion | Other |
Mother's Parents
Mother's Father
Education
Level | Some High school |
Degree | Not Completed |
Occupation: | Farming |
Siblings:
# Brothers | 1 |
# Sisters | 0 |
Other:
Languages | Japanese |
Religion | Other |
Mother's Mother
Education
Level | Some High school |
Degree | Not Completed |
Occupation: | Farming |
Siblings:
# Brothers | 2 |
# Sisters | 1 |
Other:
Languages | Japanese |
Religion | Other |