Questions
Personal Information
Talents:
Voice: | Baritone |
Instrument: Years of experience: | Guitar - 3 |
Other talents: Years of experience | Fast learner - Since childhood |
Favorite:
Color | Orange |
Food | Sloppy Joes |
Music | Classic Rock, Punk, Jazz |
Animal | Panther |
Pet | Dog |
Car | AMC Eagle, any old station wagon |
Movie | The Wizard of Oz |
Song | "Baba O'Riley" by The Who |
Play | None |
Goals:
Academic | Graduate degree |
Professional | High school teacher |
Personal | Learn as much as possible |
Religion:
Faith | None |
Denomination | N/A |
Languages:
Speak | English, Spanish |
Read | English, Spanish |
Write | English, Spanish |
Sports:
Play | Football, Basketball, Baseball |
Watch | Football |
Siblings:
# Brothers | 0 |
# Sisters | 1 |
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 | 32 - out of 36 |
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 | 3.7 | 4.0 |
College
Question | Response | on scale of |
GPA on scale of | 3.90 | 4.0 |
Graduate School
Question | Response | on scale of |
GPA on scale of | N/A |
Subjects Studied:
Major subjects | Sociology |
Minor subjects | N/A |
Degrees
Bachelor's | Pursuing BA/Sociology |
Master's | N/A |
Doctorate | N/A |
Other(s) | N/A |
Awards & Activities
High school | National History Day Competition |
College | Participation in student activism organizations |
Academic | Dean's List for two semesters |
Professional | N/A |
Political | N/A |
Personal | N/A |
Charitable | Tutoring at public library and through program tutoring inmates in prison |
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) | 16 |
Chest (inches) | 39 |
Inseam (inches) | 34 |
Waist (inches) | 34 |
Sleeve (inches) | 33 |
Wrist (inches) | 7 |
Hat size | 7 |
Shoe size | 12 |
Physical Aids
Eyes:
Vision | Near-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts | 13 |
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 |
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Color |
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Shade |
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Eyebrows:
Arch |
|
Thickness |
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Set |
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Nose:
Size |
|
Shape |
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Width |
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Length |
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Bridge |
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Nostril flare |
|
Septum |
|
Cheekbones:
Set |
|
Prominence |
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Mouth:
Size |
|
Lips |
|
Turn |
|
Teeth:
Size |
|
Set |
|
Condition |
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Chin:
Shape |
|
Prominence |
|
Cleft |
|
Ears:
Size |
|
Set |
|
Angle |
|
Lobe size |
|
Lobe attachment |
|
Hair:
Color at birth |
|
Natural color in adulthood |
|
Shade |
|
Type |
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Fullness |
|
Texture |
|
Skin:
Tone |
|
Tan ability |
|
Condition |
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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 | Commercial Driver |
Donor's Father Education:
Level | Some college |
Degree | Not Completed |
Subject | History/Education |
Donor's Father Religion:
Faith | Christian |
Denomination | Presbyterian |
Primary ethnic origins: | German |
Donor's Father Languages:
Speak | English |
Read | English |
Write | English |
Donor's Father Talents:
Voice | Baritone |
Instrument yrs experience | None |
Other yrs experience | None |
Donor's Father Physical Information
Body
Age | 50 |
Height | 6'0" |
Weight | 220 lbs. |
Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
Eye Color | Green |
Eye shade | Medium |
Vision | Near-Sighted |
Glasses | Single |
Astigmatism | Yes |
Age started wearing glasses/contacts yrs | 16 |
Hair:
Original hair color | Blond |
If gray, age turned gray | N/A |
Type | Straight |
Skin:
Skin Tone | MedL |
Skin Condition | Combination |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial Dimples | None |
Military
Served in Military | No |
Branch | N/A |
Rank | N/A |
Years of service | N/A |
Donor's Mother Personal Information
Occupation | Physical Therapist |
Donor's Mother Education:
Level | Graduate school |
Degree | Master |
Subject | Physical Therapy |
Donor's Mother Religion:
Faith | Christian |
Denomination | Catholic |
Primary ethnic origins: | Norwegian |
Donor's Mother Languages:
Speak | English |
Read | English |
Write | English |
Donor's Mother Talents:
Voice | Alto |
Instrument yrs experience | None |
Other yrs experience | None |
Donor's Mother Physical Information
Body
Age | 50 |
Height | 5'10" |
Weight | 180 lbs. |
Hands | Right-Handed |
Facial Features
Eyes:
Eye Color | Hazel |
Eye shade | Medium |
Vision | Near-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts yrs | 10 |
Hair:
Original hair color | Blond |
If gray, age turned gray | N/A |
Type | Straight |
Skin:
Skin Tone | Light |
Skin Condition | Medium |
Other:
Chin cleft | Slight |
Ear lobe | Attached |
Facial Dimples | None |
Military
Served in Military | No |
Branch | N/A |
Rank | N/A |
Years of service | N/A |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
Full/Half sibling | Full |
Sibling #1 Physical Information
Body
Sex | Female |
Age | 19 |
Height | 5'11" |
Weight | 130 lbs. |
Hands | Right-Handed |
Sibling #1 Personal Information
Occupation | Student |
Education:
Level | Some college |
Degree | Pursuing |
Subject | Early Childhood Education |
Religion:
Faith | Christian |
Denomination | Non-denominational |
Languages:
Speak | English, Spanish |
Read | English, Spanish |
Write | English, Spanish |
Talents:
Voice | Alto |
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 color | Blue |
Eye shade | Medium |
Vision | Near-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts | 15 |
Hair:
Original hair color | Blond |
If gray, age turned gray | N/A |
Type | Straight |
Skin:
Skin tone | Light |
Skin condition | Dry |
Other:
Chin cleft | Slight |
Ear lobe | Attached |
Facial dimples | None |
Military
Served in military | No |
Branch | N/A |
Rank | N/A |
Years of service | N/A |
Father's Siblings
Father's Sisters
# of Sisters | 1 |
Ages of Sisters: | 47 |
Education levels for each: | College |
Occupations for each: | Secretary |
Religions for each: | Christian |
Father's Sisters' Total Children:
# Boys | 2 |
# Girls | N/A |
Mother's Siblings
Mother's Brothers
# Brothers | 4 |
Ages of Brothers: | 60 (deceased), 60, 55, 52 |
Education levels for each: | Some college, Bachelor's, Bachelor's, Bachelor's |
Occupations for each: | Nursing Assistant, Accountant, Civil Engineer, Unknown |
Religions for each: | Catholic (all) |
Mother's Brothers' Total Children:
# Boys | 5 |
# Girls | 1 |
Mother's Sisters
# Sisters | 2 |
Ages of Sisters: | 61, 56 |
Education levels for each: | MD, Graduate |
Occupations for each: | Physician, Nurse Practitioner |
Religions for each: | Catholic, Catholic |
Mother's Sisters' Total Children:
# Boys | 1 |
# Girls | 4 |
Father's Parents
Father's Father
Education
Level | High school |
Degree | Diploma |
Subject | General Studies |
Occupation: | Construction Worker/Business Owner |
Primary ethnic origins: | German |
Siblings:
# Brothers | 1 |
# Sisters | 4 |
Other:
Languages | English |
Religion | Presbyterian |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | N/A |
Father's Mother
Education
Level | College |
Degree | Bachelor's |
Subject | Special Education |
Occupation: | Special Education Teacher |
Primary ethnic origins: | German |
Siblings:
# Brothers | 1 |
# Sisters | 1 |
Other:
Languages | English |
Religion | Catholic |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | N/A |
Mother's Parents
Mother's Father
Education
Level | College |
Degree | Bachelor's |
Subject | Psychology |
Occupation: | Mental Health Institution Administrator |
Primary ethnic origins: | Norwegian |
Siblings:
# Brothers | 2 |
# Sisters | 1 |
Other:
Languages | English, Norwegian |
Religion | Catholic |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | N/A |
Mother's Mother
Education
Level | College |
Degree | Bachelor's |
Subject | Nursing |
Occupation: | Registered Nurse |
Primary ethnic origins: | Norwegian |
Siblings:
# Brothers | 1 |
# Sisters | 3 |
Other:
Languages | English |
Religion | Catholic |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | N/A |