Questions
Personal Information
Talents:
| Voice: | Tenor |
| Instrument: Years of experience: | None |
| Other talents: Years of experience | Woodworking - 2 |
Favorite:
| Color | Blue |
| Food | Vietnamese |
| Music | Country |
| Animal | Lion |
| Pet | Dog |
| Car | Toyota Tundra |
| Movie | The Secret Life of Walter Mitty |
| Song | "Tennessee Whiskey" by Chris Stapleton |
| Play | Les Miserables |
Goals:
| Academic | Master's degree in Electrical Engineering |
| Professional | Chief Technical Lead |
| Personal | The best dad |
Religion:
| Faith | Christian |
| Denomination | Non-denominational |
Languages:
| Speak | English |
| Read | English |
| Write | English |
Sports:
| Play | Baseball/Softball |
| Watch | Football, Boxing, MMA |
Siblings:
| # Brothers | 4 |
| # Sisters | 0 |
| 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 | 1300 - out of 2400 |
| 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 | 3.3 | 4.0 |
College
| Question | Response | on scale of |
| GPA on scale of | 3.78 | 4.0 |
Graduate School
| Question | Response | on scale of |
| GPA on scale of | N/A |
Subjects Studied:
| Major subjects | Electrical Engineering |
| Minor subjects | N/A |
Degrees
| Bachelor's | BS/Electrical Engineering |
| Master's | N/A |
| Doctorate | N/A |
| Other(s) | N/A |
Awards & Activities
| High school | National honor society; National technical honor society |
| College | Recipient of several scholarships; Mentorship; Magna cum laude graduate |
| Academic | N/A |
| Professional | N/A |
| Political | N/A |
| Personal | Leadership position and award winner in a science/engineering development program; Science outreach; Robotics mentor |
| 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) | 16.5 |
| Chest (inches) | 39 |
| Inseam (inches) | 32 |
| Waist (inches) | 32 |
| Sleeve (inches) | 32 |
| Wrist (inches) | 8 |
| Hat size | 7.75 |
| Shoe size | 9.5 |
Physical Aids
Eyes:
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts | 13 |
| Laser surgery? | No |
Dental:
| Device | Braces |
| Reason | Cosmetic |
| Age range during use | 11-13 |
Other Physical Aids:
| List | None |
| Reason/cause | N/A |
Facial Features
Eyes:
| Set |
|
| Size |
|
| Shape |
|
| Color |
|
| Shade |
|
Narrow
Average
Wide
Small
Average
Large
Almond
Oval
RoundEyebrows:
| Arch |
|
| Thickness |
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| Set |
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Thin
Average
ThickNose:
| Size |
|
| 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 |
|
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 |
|
Average
Large
SmallChin:
| Shape |
|
| Prominence |
|
| Cleft |
|
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 |
|
| Type |
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| Fullness |
|
| Texture |
|
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 | Electrician |
Donor's Father Education:
| Level | Some college |
| Degree | Not Completed |
| Subject | Engineering Technology |
Donor's Father Religion:
| Faith | Christian |
| Denomination | Non-denominational |
| Primary ethnic origins: | Mexican |
Donor's Father Languages:
| Speak | Spanish, English |
| Read | Spanish, English |
| Write | Spanish, English |
Donor's Father Talents:
| Voice | Tenor |
| Instrument yrs experience | None |
| Other yrs experience | Handyman - 30 |
Donor's Father Physical Information
Body
| Age | 60 |
| Height | 5'7" |
| Weight | 170 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 | N/A |
Hair:
| Original hair color | Black |
| If gray, age turned gray | 50 |
| Type | Straight |
Skin:
| Skin Tone | MedL |
| Skin Condition | Combination |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial Dimples | None |
Military
| Served in Military | Yes |
| Branch | Army |
| Rank | Corporal |
| Years of service | 6 |
Donor's Mother Personal Information
| Occupation | Supervisor |
Donor's Mother Education:
| Level | High school |
| Degree | Other |
| Subject | General Educational Development (GED) Certificate |
Donor's Mother Religion:
| Faith | Christian |
| Denomination | Non-denominational |
| Primary ethnic origins: | Mexican |
Donor's Mother Languages:
| Speak | Spanish, English |
| Read | Spanish, English |
| Write | Spanish, English |
Donor's Mother Talents:
| Voice | Alto |
| Instrument yrs experience | None |
| Other yrs experience | Cooking - 30+ |
Donor's Mother Physical Information
Body
| Age | 58 |
| Height | 4'11" |
| Weight | 130 lbs. |
| Hands | Right-Handed |
Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Dark |
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 30 |
Hair:
| Original hair color | Brown |
| If gray, age turned gray | 50 |
| Type | Wavy |
Skin:
| Skin Tone | MedL |
| Skin Condition | Medium |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial Dimples | Slight |
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 | Half |
Sibling #1 Physical Information
Body
| Sex | Male |
| Age | 37 |
| Height | 5'11" |
| Weight | 170 lbs. |
| Hands | Right-Handed |
Sibling #1 Personal Information
| Occupation | AC Repairman |
Education:
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
Religion:
| Faith | Christian |
| Denomination | Non-denominational |
Languages:
| Speak | English |
| Read | English |
| Write | English |
Talents:
| Voice | Tenor |
| Instrument Years of experience | None |
| Other Years of experience | None |
Sibling #1 Children:
| # Boys Ages: | 2 - 12, 6 |
| # Girls Ages: | 3 - 15, 8, 1 |
Sibling #1 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | N/A |
Hair:
| Original hair color | Brown |
| If gray, age turned gray | N/A |
| Type | Wavy |
Skin:
| Skin tone | Med |
| Skin condition | Medium |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial dimples | Slight |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | N/A |
Donor's Sibling #2
| Full/Half sibling | Half |
Sibling #2 Physical Information
Body
| Sex | Male |
| Age | 35 |
| Height | 5'11" |
| Weight | 210 lbs. |
| Hands | Right-Handed |
Sibling #2 Personal Information
| Occupation | Teacher |
Education:
| Level | College |
| Degree | Bachelor |
| Subject | Education |
Religion:
| Faith | Christian |
| Denomination | Non-denominational |
Languages:
| Speak | Spanish, English |
| Read | Spanish, English |
| Write | Spanish, English |
Talents:
| Voice | Tenor |
| Instrument Years of experience | None |
| Other Years of experience | None |
Sibling #2 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #2 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Dark |
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts | 32 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | 30 |
| Type | Straight |
Skin:
| Skin tone | MedDk |
| Skin condition | Medium |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial dimples | None |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | N/A |
Donor's Sibling #3
| Full/Half sibling | Half |
Sibling #3 Physical Information
Body
| Sex | Male |
| Age | 28 |
| Height | 5'8" |
| Weight | 200 lbs. |
| Hands | Right-Handed |
Sibling #3 Personal Information
| Occupation | Audio Producer |
Education:
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
Religion:
| Faith | None |
| Denomination | N/A |
Languages:
| Speak | English |
| Read | English |
| Write | English |
Talents:
| Voice | Tenor |
| Instrument Years of experience | None |
| Other Years of experience | None |
Sibling #3 Children:
| # Boys Ages: | 1 - 10 |
| # Girls Ages: | 0 |
Sibling #3 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Dark |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | N/A |
Hair:
| Original hair color | Brown |
| If gray, age turned gray | N/A |
| Type | Wavy |
Skin:
| Skin tone | MedL |
| Skin condition | Medium |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial dimples | None |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | N/A |
Donor's Sibling #4
| Full/Half sibling | Half |
Sibling #4 Physical Information
Body
| Sex | Male |
| Age | 12 |
| Height | 5'6" |
| Weight | 160 lbs. |
| Hands | Right-Handed |
Sibling #4 Personal Information
| Occupation | Student |
Education:
| Level | Grade school |
| Degree | Pursuing |
| Subject | General Studies |
Religion:
| Faith | Christian |
| Denomination | Non-denominational |
Languages:
| Speak | Spanish, English |
| Read | Spanish, English |
| Write | Spanish, English |
Talents:
| Voice | Tenor |
| Instrument Years of experience | None |
| Other Years of experience | None |
Sibling #4 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #4 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Dark |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | N/A |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Straight |
Skin:
| Skin tone | MedL |
| Skin condition | Oily |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial dimples | None |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | N/A |
Father's Siblings
Father's Brothers
| # of Brothers | 2 |
| Ages of Brothers: | 53, 44 (deceased) |
| Education levels for each: | High school, High school |
| Occupations for each: | Foreman, Food Service Industry |
| Religions for each: | Christian, Christian |
Father's Brothers' Total Children:
| # Boys | 4 |
| # Girls | 3 |
Father's Sisters
| # of Sisters | 2 |
| Ages of Sisters: | 64, 58 |
| Education levels for each: | High school, High school |
| Occupations for each: | Supervisor, Project Manager |
| Religions for each: | Christian, Christian |
Father's Sisters' Total Children:
| # Boys | 1 |
| # Girls | 4 |
Mother's Siblings
Mother's Brothers
| # Brothers | 4 |
| Ages of Brothers: | 59, 57 (deceased), 49 (deceased), 48 |
| Education levels for each: | Some college, High school (HS), HS, HS |
| Occupations for each: | Municipal Worker (retired), Contractor/Supervisor, None, Truck Driver |
| Religions for each: | Catholic (all) |
Mother's Brothers' Total Children:
| # Boys | 1 |
| # Girls | 2 |
Mother's Sisters
| # Sisters | 2 |
| Ages of Sisters: | 68, 50 |
| Education levels for each: | High school, High school |
| Occupations for each: | Customer Service, Homemaker |
| Religions for each: | Christian, Catholic |
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: | Chef |
| Primary ethnic origins: | Mexican |
Siblings:
| # Brothers | 2 |
| # Sisters | 1 |
Other:
| Languages | Spanish, English |
| Religion | Christian |
Military
| Branch | Air Force |
| Rank | Airman First Class |
| Service Yrs | 4 |
Father's Mother
Education
| Level | Grade school |
| Degree | None |
| Subject | General Studies |
| Occupation: | Homemaker |
| Primary ethnic origins: | Mexican |
Siblings:
| # Brothers | 0 |
| # Sisters | 2 |
Other:
| Languages | Spanish |
| Religion | Christian |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Mother's Parents
Mother's Father
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Contractor |
| Primary ethnic origins: | Mexican |
Siblings:
| # Brothers | 0 |
| # Sisters | 0 |
Other:
| Languages | Spanish, English |
| Religion | Catholic |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Mother's Mother
Education
| Level | No formal education |
| Degree | None |
| Subject | N/A |
| Occupation: | Homemaker |
| Primary ethnic origins: | Mexican |
Siblings:
| # Brothers | 0 |
| # Sisters | 0 |
Other:
| Languages | Spanish |
| Religion | Catholic |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |