Questions

Academics
Military
Physical Features
Physical Aids
Facial Features
Family Information
Donor's Parents
Donor's Siblings
Father's Siblings
Mother's Siblings
Father's Parents
Mother's Parents

Personal Information

Talents:
Voice:Bass
Instrument:
Years of experience:		Drums - Since childhood
Other talents:
Years of experience		Cooking - 5
Favorite:
ColorNorth Carolina Blue
FoodCheesesteak
MusicHard Bop Jazz
AnimalKoala
PetSiberian Husky
CarLamborghini
MovieInception
Song"For Once In My Life" by Stevie Wonder
PlayThe Book of Mormon
Goals:
AcademicFinish graduate certificate for Health Care Administration
Professional Become director of my department
PersonalOwn home within three years
Religion:
Faith Other
Denomination Agnostic
Languages:
SpeakEnglish
ReadEnglish, some Spanish
WriteEnglish
Sports:
PlayBasketball, Baseball, Tennis
WatchBasketball, Football, Baseball, Hockey, Tennis
Siblings:
# Brothers0
# Sisters1
Are you a twin?
Identical or fraternal?		No
# of twins in your family0
# Identical sets0
# Fraternal sets0

Academics

Standard Test Score: provide score or denote N/A if not taken
SAT
on scale of		1200 - out of 1600
ACT
on scale of		N/A
GRE
on scale of		N/A
MCAT
on scale of		N/A
LSAT
on scale of		N/A
GMAT
on scale of		N/A
TOEFL
on scale of		N/A
Other
on scale of		N/A
High School
Question Response on scale of
GPA
on scale of 		3.754.0
College
Question Response on scale of
GPA
on scale of 		3.394.0
Graduate School
Question Response on scale of
GPA
on scale of 		Pass(Pass/fail system)
Subjects Studied:
Major subjectsBusiness Management
Minor subjectsN/A
Degrees
Bachelor'sBS/Business Management
Master'sN/A
DoctorateN/A
Other(s)Pursuing Graduate Certificate for Health Care Administration
Awards & Activities
High schoolClass Clown, Honors Society, Future Business Leaders of America
CollegeIntramural basketball
AcademicDean's List
Professional N/A
Political N/A
Personal N/A
Charitable Have volunteered time helping prepare meals for veterans
OthersN/A

Military

Served in militaryNo
BranchN/A
RankN/A
Years of serviceN/A

Physical Features

HandsRight-Handed
FingersMedium
Sizes & Measurements
Neck (inches)15
Chest (inches)34
Inseam (inches)30
Waist (inches)32
Sleeve (inches)30
Wrist (inches)7
Hat size9
Shoe size11

Physical Aids

Eyes:
Vision Near-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts8
Laser surgery?No
Dental:
DeviceNone
ReasonN/A
Age range during useN/A
Other Physical Aids:
ListNone
Reason/causeN/A

Facial Features

Eyes:
Set
  • NarrowNarrow
  • AverageAverage
  • WideWide
Size
  • SmallSmall
  • AverageAverage
  • LargeLarge
Shape
  • AlmondAlmond
  • OvalOval
  • RoundRound
Color
  • Black
  • Blue
  • Green
  • Hazel
  • Brown
Shade
  • Light
  • Medium
  • Dark
Eyebrows:
Arch
  • Flat
  • Medium
  • High
Thickness
  • ThinThin
  • AverageAverage
  • ThickThick
Set
  • Narrow
  • Average
  • Wide
Nose:
Size
  • Small
  • Medium
  • Large
Shape
  • RoundRound
  • StraightStraight
  • WideWide
Width
  • Narrow
  • Average
  • Wide
Length
  • Short
  • Average
  • Long
Bridge
  • ConvexConvex
  • StraightStraight
  • ConcaveConcave
Nostril flare
  • Small
  • Average
  • Wide
Septum
  • Thin
  • Average
  • Thick
Cheekbones:
Set
  • Low
  • Average
  • High
Prominence
  • Slight
  • Medium
  • Strong
Mouth:
Size
  • SmallSmall
  • AverageAverage
  • LargeLarge
Lips
  • ThinThin
  • AverageAverage
  • FullFull
Turn
  • Downward
  • Straight
  • Upward
Teeth:
Size
  • AverageAverage
  • LargeLarge
  • SmallSmall
Set
  • Underbite
  • Even
  • Overbite
Condition
  • Poor
  • Fair
  • Good
Chin:
Shape
  • RoundRound
  • OvalOval
  • SquareSquare
Prominence
  • Slight
  • Average
  • Strong
Cleft
  • NoneNone
  • SlightSlight
  • StrongStrong
Ears:
Size
  • SmallSmall
  • AverageAverage
  • LargeLarge
Set
  • Low
  • Average
  • High
Angle
  • FlatFlat
  • AverageAverage
  • AcuteAcute
Lobe size
  • Small
  • Medium
  • Large
Lobe attachment
  • DetachedDetached
  • AttachedAttached
Hair:
Color at birth
  • Blond
  • Brown
  • Auburn
  • Red
  • Black
  • grey
Natural color in adulthood
  • Blond
  • Brown
  • Auburn
  • Red
  • Black
  • grey
Shade
  • Light
  • Medium
  • Dark
Type
  • Straight
  • Wavy
  • Curly
Fullness
  • Thin
  • Medium
  • Thick
Texture
  • Fine
  • Coarse
  • Medium
Skin:
Tone
  • Light
  • MedL
  • Med
  • MedDk
  • Dark
Tan ability
  • None
  • Slight
  • Medium
  • Easy
Condition
  • Oily
  • Medium
  • Combination
  • Dry
Hairline:
Forehead
  • Low
  • Average
  • High
Contour
  • Straight
  • Slight Curve
  • Widow Peak
Other Facial Features:
Moles
  • None
  • One
  • Several
Freckles
  • None
  • Several
  • Moderate
  • Numerous
Dimples
  • None
  • Slight
  • Medium
  • Deep
Adam's apple
  • Slight
  • Medium
  • Strong
Facial Hair
Thickness
  • Thin
  • Medium
  • Dense
Shade
  • Light
  • Medium
  • Dark

Family Information

Donor's Parents
Donor's Father Personal Information
OccupationBusiness Executive
Donor's Father Education:
LevelCollege
DegreeBachelor
SubjectPsychology
Donor's Father Religion:
Faith Jewish
Denomination Conservative
Primary ethnic origins:Russian, Polish (Jewish)
Donor's Father Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Donor's Father Talents:
VoiceTenor
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Father Physical Information
Body
Age62
Height5'10"
Weight185 lbs.
HandsRight-Handed
Donor's Father Facial Features
Eyes:
Eye ColorBrown
Eye shadeMedium
Vision Near-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts
yrs		20
Hair:
Original hair color Blond
If gray, age turned gray50-55, salt & pepper now
TypeStraight
Skin:
Skin ToneMed
Skin ConditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial DimplesSlight
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of serviceN/A
Donor's Mother Personal Information
Occupation Banking
Donor's Mother Education:
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Donor's Mother Religion:
Faith Jewish
Denomination Conservative
Primary ethnic origins:Polish (Jewish), Irish, German
Donor's Mother Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Donor's Mother Talents:
VoiceAlto
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Mother Physical Information
Body
Age56
Height5'1"
Weight135 lbs.
HandsRight-Handed
Facial Features
Eyes:
Eye ColorBrown
Eye shadeMedium
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts
yrs		N/A
Hair:
Original hair color Red
If gray, age turned grayN/A
TypeCurly
Skin:
Skin ToneLight
Skin ConditionDry
Other:
Chin cleftNone
Ear lobeAttached
Facial DimplesSlight
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of serviceN/A
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
Full/Half siblingFull
Sibling #1 Physical Information
Body
SexFemale
Age35
Height5'3"
Weight140 lbs.
HandsRight-Handed
Sibling #1 Personal Information
Occupation Store Manager
Education:
LevelSome college
DegreePursuing
SubjectNursing
Religion:
Faith Jewish
Denomination Conservative
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceAlto
Instrument
Years of experience		None
Other
Years of experience		None
Sibling #1 Children:
# Boys
Ages:		0
# Girls
Ages:		0
Sibling #1 Facial Features
Eyes:
Eye colorBrown
Eye shadeMedium
Vision Near-Sighted
GlassesSingle - (Until laser surgery at age 30)
AstigmatismNo
Age started wearing glasses/contacts10
Hair:
Original hair color Black
If gray, age turned grayN/A
TypeStraight
Skin:
Skin toneMedL
Skin conditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial dimplesMedium
Military
Served in militaryNo
BranchN/A
RankN/A
Years of serviceN/A
Father's Siblings
Father's Sisters
# of Sisters1
Ages of Sisters:58
Education levels for each:High school
Occupations for each:Bus Driver
Religions for each:None
Father's Sisters' Total Children:
# BoysN/A
# Girls2
Mother's Siblings
Mother's Sisters
# Sisters1
Ages of Sisters:62
Education levels for each:High school
Occupations for each:Marketing
Religions for each:Catholic
Mother's Sisters' Total Children:
# Boys2
# GirlsN/A
Father's Parents
Father's Father
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Store Owner
Primary ethnic origins:Polish (Jewish)
Siblings:
# Brothers2
# Sisters1
Other:
LanguagesEnglish
ReligionJewish
Military
BranchN/A
RankN/A
Service YrsN/A
Father's Mother
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Store Owner
Primary ethnic origins:Russian (Jewish)
Siblings:
# Brothers1
# Sisters0
Other:
LanguagesEnglish
ReligionJewish
Military
BranchN/A
RankN/A
Service YrsN/A
Mother's Parents
Mother's Father
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Department Head
Primary ethnic origins:Irish, German
Siblings:
# Brothers1
# Sisters2
Other:
LanguagesEnglish
ReligionNone
Military
BranchArmy
RankPrivate First Class
Service Yrs4
Mother's Mother
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Bookkeeper
Primary ethnic origins:Polish (Jewish)
Siblings:
# Brothers1
# Sisters1
Other:
LanguagesEnglish
ReligionJewish
Military
BranchN/A
RankN/A
Service YrsN/A