Questions
Personal Information
Talents:
| Voice: | Tenor |
| Instrument: Years of experience: | Piano - 3 |
| Other talents: Years of experience | Soccer, Photography, Volleyball - 25, 11, 10 |
Favorite:
| Color | Red |
| Food | Mediterranean Diet |
| Music | Gospel, Inspirational music |
| Animal | Lion |
| Pet | Cat, Dog |
| Car | Mercedes |
| Movie | Pursuit of Happyness |
| Song | Not Specific |
| Play | Grey's Anatomy, Private Practice, ER |
Goals:
| Academic | Pursue further education: Cardiologist or cardiac surgeon |
| Professional | Medicine |
| Personal | Financial stability, Community work |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Swahili, French, Luo |
| Read | English, Swahili, French, Luo |
| Write | English, Swahili, French, Luo |
Sports:
| Play | Soccer, Martial Arts |
| Watch | Soccer, Football, Basketball |
Siblings:
| # Brothers | 2 |
| # Sisters | 3 |
| Are you a twin? Identical or fraternal? | No |
| # of twins in your family | 0 |
| # Identical sets | 0 |
| # Fraternal sets | 0 |
Academics
Standard Test Score: provide score or denote N/A if not taken
| SAT on scale of | N/A |
| ACT on scale of | N/A |
| GRE on scale of | 1200 - out of 1600 |
| MCAT on scale of | N/A |
| LSAT on scale of | N/A |
| GMAT on scale of | N/A |
| TOEFL on scale of | 255 - out of 300 |
| Other on scale of | N/A |
High School
| Question | Response | on scale of |
| GPA on scale of | 3.8 | 4.0 |
College
| Question | Response | on scale of |
| GPA on scale of | 3.40 | 4.0 |
Graduate School
| Question | Response | on scale of |
| GPA on scale of | 3.48 | 4.0 |
Subjects Studied:
| Major subjects | Pharmacology, Emergency Medicine, Surgery, Internal Medicine, Cardiology |
| Minor subjects | HIPAA Certification, Geriatrics |
Degrees
| Bachelor's | BS/Cell and Molecular Biology; Allied Health; Pre-Medicine |
| Master's | Master of Physician Assistant Studies |
| Doctorate | N/A |
| Other(s) | N/A |
Awards & Activities
| High school | School captain, Handball, Martial Arts |
| College | Presidential Scholarship awards, Scholarships and grants |
| Academic | Master's, Bachelor's degree, PA Certification |
| Professional | Licensure to practice Medicine |
| Political | N/A |
| Personal | N/A |
| Charitable | United Way, Children International, Rotary International |
| Others | N/A |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Physical Features
| Hands | Right-Handed |
| Fingers | Medium |
Sizes & Measurements
| Neck (inches) | 15 |
| Chest (inches) | 36 |
| Inseam (inches) | 32 |
| Waist (inches) | 32 |
| Sleeve (inches) | 33 |
| Wrist (inches) | 7 |
| Hat size | 7.125 |
| Shoe size | 10.5 |
Physical Aids
Eyes:
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts | 24 |
| Laser surgery? | No |
Dental:
| Device | None |
| Reason | N/A |
| Age range during use | N/A |
Other Physical Aids:
| List | None |
| Reason/cause | N/A |
Facial Features
Eyes:
| Set |
|
| Size |
|
| Shape |
|
| Color |
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| Shade |
|
Narrow
Average
Wide
Small
Average
Large
Almond
Oval
RoundEyebrows:
| Arch |
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| Thickness |
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| Set |
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Thin
Average
ThickNose:
| Size |
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| Shape |
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| Width |
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| Length |
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| Bridge |
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| Nostril flare |
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| Septum |
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Round
Straight
Wide
Convex
Straight
ConcaveCheekbones:
| Set |
|
| Prominence |
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Mouth:
| Size |
|
| Lips |
|
| Turn |
|
Small
Average
Large
Thin
Average
FullTeeth:
| Size |
|
| Set |
|
| Condition |
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Average
Large
SmallChin:
| Shape |
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| Prominence |
|
| Cleft |
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Round
Oval
Square
None
Slight
StrongEars:
| Size |
|
| Set |
|
| Angle |
|
| Lobe size |
|
| Lobe attachment |
|
Small
Average
Large
Flat
Average
Acute
Detached
AttachedHair:
| Color at birth |
|
| Natural color in adulthood |
|
| Shade |
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| Type |
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| Fullness |
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| Texture |
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Skin:
| Tone |
|
| Tan ability |
|
| Condition |
|
Hairline:
| Forehead |
|
| Contour |
|
Other Facial Features:
| Moles |
|
| Freckles |
|
| Dimples |
|
| Adam's apple |
|
Facial Hair
| Thickness |
|
| Shade |
|
Family Information
Donor's Parents
Donor's Father Personal Information
| Occupation | Teacher (retired) |
Donor's Father Education:
| Level | College |
| Degree | Diploma |
| Subject | Education |
Donor's Father Religion:
| Faith | Christian |
| Denomination | Catholic |
| Primary ethnic origins: | African (Luo) |
Donor's Father Languages:
| Speak | English, Swahili, Luo |
| Read | English, Swahili, Luo |
| Write | English, Swahili, Luo |
Donor's Father Talents:
| Voice | Baritone |
| Instrument yrs experience | None |
| Other yrs experience | None |
Donor's Father Physical Information
Body
| Age | 64 |
| Height | 5'11" |
| Weight | 160 lbs. |
| Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Dark |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Curly |
Skin:
| Skin Tone | Dark |
| Skin Condition | Medium |
Other:
| Chin cleft | Medium |
| Ear lobe | Detached |
| Facial Dimples | Slight |
Military
| Served in Military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Mother Personal Information
| Occupation | IT Specialist |
Donor's Mother Education:
| Level | College |
| Degree | Diploma |
| Subject | Information Technology |
Donor's Mother Religion:
| Faith | Christian |
| Denomination | Catholic |
| Primary ethnic origins: | African (Luo) |
Donor's Mother Languages:
| Speak | English, Swahili, Luo |
| Read | English, Swahili, Luo |
| Write | English, Swahili, Luo |
Donor's Mother Talents:
| Voice | Soprano |
| Instrument yrs experience | Piano, Drum, Guitar - 10, 5, 5 |
| Other yrs experience | Volleyball, Track - 30, 30 |
Donor's Mother Physical Information
Body
| Age | 53 |
| Height | 5'10" |
| Weight | 150 lbs. |
| Hands | Right-Handed |
Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Curly |
Skin:
| Skin Tone | Med |
| Skin Condition | Medium |
Other:
| Chin cleft | Slight |
| Ear lobe | Detached |
| Facial Dimples | Medium |
Military
| Served in Military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
| Full/Half sibling | Full |
Sibling #1 Physical Information
Body
| Sex | Male |
| Age | 35 |
| Height | 5'10" |
| Weight | 160 lbs. |
| Hands | Right-Handed |
Sibling #1 Personal Information
| Occupation | Corporate Insurance Risk Analyst |
Education:
| Level | Graduate school |
| Degree | Master |
| Subject | Insurance |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Swahili, Luo |
| Read | English, Swahili, Luo |
| Write | English, Swahili, Luo |
Talents:
| Voice | Baritone |
| Instrument Years of experience | None |
| Other Years of experience | Soccer - 10 |
Sibling #1 Children:
| # Boys Ages: | 1 - 1 |
| # Girls Ages: | 0 |
Sibling #1 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Curly |
Skin:
| Skin tone | MedDk |
| Skin condition | Medium |
Other:
| Chin cleft | Slight |
| Ear lobe | Detached |
| Facial dimples | Slight |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Sibling #2
| Full/Half sibling | Full |
Sibling #2 Physical Information
Body
| Sex | Female |
| Age | 33 |
| Height | 5'9" |
| Weight | 125 lbs. |
| Hands | Right-Handed |
Sibling #2 Personal Information
| Occupation | Social Scientist |
Education:
| Level | Graduate school |
| Degree | Master |
| Subject | Social Science |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Swahili, Luo |
| Read | English, Swahili, Luo |
| Write | English, Swahili, Luo |
Talents:
| Voice | Soprano |
| Instrument Years of experience | None |
| Other Years of experience | Performance Arts - 18 |
Sibling #2 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #2 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Wavy |
Skin:
| Skin tone | MedDk |
| Skin condition | Medium |
Other:
| Chin cleft | Slight |
| Ear lobe | Detached |
| Facial dimples | Slight |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Sibling #3
| Full/Half sibling | Full |
Sibling #3 Physical Information
Body
| Sex | Female |
| Age | 29 |
| Height | 5'11" |
| Weight | 140 lbs. |
| Hands | Right-Handed |
Sibling #3 Personal Information
| Occupation | Geriatric Registered Nurse |
Education:
| Level | College |
| Degree | Bachelor |
| Subject | Nursing |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Swahili, Luo, German |
| Read | English, Swahili, Luo, German |
| Write | English, Swahili, Luo, German |
Talents:
| Voice | Soprano |
| Instrument Years of experience | None |
| Other Years of experience | Performance Arts - 15 |
Sibling #3 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #3 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Wavy |
Skin:
| Skin tone | MedDk |
| Skin condition | Medium |
Other:
| Chin cleft | Slight |
| Ear lobe | Detached |
| Facial dimples | Slight |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Sibling #4
| Full/Half sibling | Full |
Sibling #4 Physical Information
Body
| Sex | Male |
| Age | 27 |
| Height | 5'11" |
| Weight | 160 lbs. |
| Hands | Left-Handed |
Sibling #4 Personal Information
| Occupation | Mid-level Provider |
Education:
| Level | Graduate school |
| Degree | Master |
| Subject | Physician Assistant |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Swahili, Luo, German |
| Read | English, Swahili, Luo, German |
| Write | English, Swahili, Luo, German |
Talents:
| Voice | Baritone |
| Instrument Years of experience | None |
| Other Years of experience | Martial Arts, Soccer - 15, 11 |
Sibling #4 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #4 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Curly |
Skin:
| Skin tone | MedDk |
| Skin condition | Medium |
Other:
| Chin cleft | Slight |
| Ear lobe | Detached |
| Facial dimples | Slight |
Military
| Served in military | Yes |
| Branch | US Army |
| Rank | Sergeant |
| Years of service | 2 |
Donor's Sibling #5
| Full/Half sibling | Full |
Sibling #5 Physical Information
Body
| Sex | Female |
| Age | 19 |
| Height | 5'8" |
| Weight | 120 lbs. |
| Hands | Right-Handed |
Sibling #5 Personal Information
| Occupation | Student |
Education:
| Level | College |
| Degree | Pursuing |
| Subject | Pre-Medicine |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Swahili, Luo, French, German |
| Read | English, Swahili, Luo, French, German |
| Write | English, Swahili, Luo, French, German |
Talents:
| Voice | Alto |
| Instrument Years of experience | None |
| Other Years of experience | Performance Arts - 7 |
Sibling #5 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #5 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Curly |
Skin:
| Skin tone | MedDk |
| Skin condition | Medium |
Other:
| Chin cleft | Slight |
| Ear lobe | Detached |
| Facial dimples | Medium |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Father's Siblings
Father's Brothers
| # of Brothers | 2 |
| Ages of Brothers: | 46 (deceased), 45 |
| Education levels for each: | College, College |
| Occupations for each: | Communications Engineer, Mechanical Engineer |
| Religions for each: | Christian, Christian |
Father's Brothers' Total Children:
| # Boys | 3 |
| # Girls | 8 |
Father's Sisters
| # of Sisters | 3 |
| Ages of Sisters: | 65, 50, 45 (deceased) |
| Education levels for each: | Associate's, Master's, Associate's |
| Occupations for each: | Teacher, Chemist, Businesswoman |
| Religions for each: | Christian (All) |
Father's Sisters' Total Children:
| # Boys | 12 |
| # Girls | 7 |
Mother's Siblings
Mother's Brothers
| # Brothers | 3 |
| Ages of Brothers: | 50 (deceased), 62, 60 |
| Education levels for each: | High school, Bachelor's, Bachelor's |
| Occupations for each: | Farmer, Communications Technology Director, Communications Technology Director |
| Religions for each: | Christian (all) |
Mother's Brothers' Total Children:
| # Boys | 6 |
| # Girls | 4 |
Mother's Sisters
| # Sisters | 2 |
| Ages of Sisters: | 40 (deceased), 45 (deceased) |
| Education levels for each: | Bachelor's, Bachelor's |
| Occupations for each: | IT Specialist, IT Specialist |
| Religions for each: | Christian, Christian |
Mother's Sisters' Total Children:
| # Boys | 4 |
| # Girls | 2 |
Father's Parents
Father's Father
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Business Entrepreneur |
| Primary ethnic origins: | African (Luo) |
Siblings:
| # Brothers | 2 |
| # Sisters | 2 |
Other:
| Languages | Luo, Swahili, English |
| Religion | Christian |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Father's Mother
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Business Entrepreneur |
| Primary ethnic origins: | African (Luo) |
Siblings:
| # Brothers | 4 |
| # Sisters | 4 |
Other:
| Languages | Luo, Swahili, English |
| Religion | Christian |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Mother's Parents
Mother's Father
Education
| Level | Associate's |
| Degree | Business |
| Subject | Commerce |
| Occupation: | Business Entrepreneur |
| Primary ethnic origins: | African (Luo) |
Siblings:
| # Brothers | 6 |
| # Sisters | 6 |
Other:
| Languages | Luo, Swahili, English |
| Religion | Christian |
Military
| Branch | Army |
| Rank | General |
| Service Yrs | 20 |
Mother's Mother
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Business Entrepreneur |
| Primary ethnic origins: | African (Luo) |
Siblings:
| # Brothers | 3 |
| # Sisters | 3 |
Other:
| Languages | Luo, Swahili, English, Luhya |
| Religion | Christian |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |