Questions
Personal Information
Talents:
| Voice: | Bass |
| Instrument: Years of experience: | None |
| Other talents: Years of experience | Soccer, woodworking, weightlifting, public speaking - 13, 13, 10, 5 |
Favorite:
| Color | Light blue |
| Food | Mediterranean |
| Music | Classical |
| Animal | Enteroctopus dofleini |
| Pet | Dog |
| Car | Tesla Roadster |
| Movie | Interstellar |
| Song | Moonlight Sonata No. 14 |
| Play | The Odyssey |
Goals:
| Academic | PhD |
| Professional | Business owner |
| Personal | Making a difference in the lives of as many people as possible |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Japanese |
| Read | English, Japanese |
| Write | English, Japanese |
Sports:
| Play | Soccer, tennis, track and field, golf |
| Watch | Any |
Siblings:
| # Brothers | 1 |
| # Sisters | 2 |
| 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 | 27 - 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 | 3.2 | 4.0 |
Graduate School
| Question | Response | on scale of |
| GPA on scale of | N/A |
Subjects Studied:
| Major subjects | Biology |
| Minor subjects | Japanese |
Degrees
| Bachelor's | BS/Biology |
| Master's | N/A |
| Doctorate | N/A |
| Other(s) | AA/Japanese |
Awards & Activities
| High school | Graduation speaker |
| College | Honors, certificate of excellence, runner-up graduation speaker |
| Academic | Honors, certificate of excellence, runner-up graduation speaker |
| Professional | N/A |
| Political | N/A |
| Personal | Golfing, Tennis, Cooking new recipes each week, making beef jerky |
| Charitable | Planting trees with non-profit group, feeding people in need |
| Others | Computer programming, webpage design, writing science fiction |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | N/A |
Physical Features
| Hands | Right-Handed |
| Fingers | Long |
Sizes & Measurements
| Neck (inches) | 15 |
| Chest (inches) | 40 |
| Inseam (inches) | 32 |
| Waist (inches) | 32 |
| Sleeve (inches) | 35 |
| Wrist (inches) | 6.5 |
| Hat size | 7.12 |
| Shoe size | 11 |
Physical Aids
Eyes:
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | N/A |
| Laser surgery? | No |
Dental:
| Device | Braces and Retainer |
| Reason | Cosmetic |
| Age range during use | 13-14 |
Other Physical Aids:
| List | N/A |
| Reason/cause | N/A |
Facial Features
Eyes:
| Set |
|
| Size |
|
| Shape |
|
| Color |
|
| Shade |
|
Narrow
Average
Wide
Small
Average
Large
Almond
Oval
RoundEyebrows:
| Arch |
|
| Thickness |
|
| Set |
|
Thin
Average
ThickNose:
| Size |
|
| Shape |
|
| Width |
|
| Length |
|
| Bridge |
|
| Nostril flare |
|
| Septum |
|
Round
Straight
Wide
Convex
Straight
ConcaveCheekbones:
| Set |
|
| Prominence |
|
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 |
|
| 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 | Business owner |
Donor's Father Education:
| Level | College |
| Degree | Bachelor |
| Subject | Agriculture |
Donor's Father Religion:
| Faith | Other |
| Denomination | Buddhism |
| Primary ethnic origins: | Japanese |
Donor's Father Languages:
| Speak | English, Japanese |
| Read | English, Japanese |
| Write | English, Japanese |
Donor's Father Talents:
| Voice | Bass |
| Instrument yrs experience | Trumpet - 10 |
| Other yrs experience | N/A |
Donor's Father Physical Information
Body
| Age | 52 |
| Height | 5'7'' |
| Weight | 160 lbs |
| Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Medium |
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 28 - 24 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Curly |
Skin:
| Skin Tone | MedDk |
| 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 Mother Personal Information
| Occupation | Teacher |
Donor's Mother Education:
| Level | College |
| Degree | Bachelor |
| Subject | Art |
Donor's Mother Religion:
| Faith | Christian |
| Denomination | Catholic |
| Primary ethnic origins: | English-Polish |
Donor's Mother Languages:
| Speak | English |
| Read | English |
| Write | English |
Donor's Mother Talents:
| Voice | Alto |
| Instrument yrs experience | N/A |
| Other yrs experience | N/A |
Donor's Mother Physical Information
Body
| Age | 55 |
| Height | 5'5'' |
| Weight | 170 lbs |
| Hands | Right-Handed |
Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Medium |
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 30 - 25 |
Hair:
| Original hair color | Brown |
| If gray, age turned gray | N/A |
| Type | Straight |
Skin:
| Skin Tone | Med |
| Skin Condition | Medium |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial Dimples | Medium |
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 | 25 |
| Height | 5'5'' |
| Weight | 150 lbs. |
| Hands | Right-Handed |
Sibling #1 Personal Information
| Occupation | Journalist |
Education:
| Level | College |
| Degree | Bachelor |
| Subject | Journalism |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Japanese |
| Read | English, Japanese |
| Write | English, Japanese |
Talents:
| Voice | Alto |
| Instrument Years of experience | N/A |
| Other Years of experience | N/A |
Sibling #1 Children:
| # Boys Ages: | 0 |
| # 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 | N/A |
Hair:
| Original hair color | Brown |
| If gray, age turned gray | N/A |
| Type | Straight |
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 | Full |
Sibling #2 Physical Information
Body
| Sex | Female |
| Age | 20 |
| Height | 5'6'' |
| Weight | 130 lbs |
| Hands | Right-Handed |
Sibling #2 Personal Information
| Occupation | Student/Food Service |
Education:
| Level | College |
| Degree | Pursuing |
| Subject | History |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English, Japanese |
| Read | English, Japanese |
| Write | English, Japanese |
Talents:
| Voice | Alto |
| Instrument Years of experience | N/A |
| Other Years of experience | N/A |
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 | N/A |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Straight |
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 #3
| Full/Half sibling | Full |
Sibling #3 Physical Information
Body
| Sex | Male |
| Age | 14 |
| Height | 5'2'' |
| Weight | 140 lbs |
| Hands | Right-Handed |
Sibling #3 Personal Information
| Occupation | Student |
Education:
| Level | High school |
| Degree | Pursuing |
| Subject | General studies |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Languages:
| Speak | English |
| Read | English |
| Write | English |
Talents:
| Voice | Baritone |
| Instrument Years of experience | Trumpet - 4 |
| Other Years of experience | N/A |
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 | N/A |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Straight |
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 |
Father's Siblings
Father's Sisters
| # of Sisters | 3 |
| Ages of Sisters: | 58, 54, 45 |
| Education levels for each: | Associate's, Associate's, Associate's |
| Occupations for each: | Restauranteur, Bar owner, Teacher |
| Religions for each: | Buddhism, Buddhism, Buddhism |
Father's Sisters' Total Children:
| # Boys | 1 |
| # Girls | 6 |
Mother's Siblings
Mother's Brothers
| # Brothers | 1 |
| Ages of Brothers: | 50 |
| Education levels for each: | Bachelor's |
| Occupations for each: | Human Resources |
| Religions for each: | Christian |
Mother's Brothers' Total Children:
| # Boys | N/A |
| # Girls | N/A |
Father's Parents
Father's Father
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Business owner |
| Primary ethnic origins: | Japanese |
Siblings:
| # Brothers | 0 |
| # Sisters | 1 |
Other:
| Languages | Japanese |
| Religion | Buddhism |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Father's Mother
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Store manager |
| Primary ethnic origins: | Japanese |
Siblings:
| # Brothers | 0 |
| # Sisters | 0 |
Other:
| Languages | Japanese |
| Religion | Buddhism |
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: | Foreman |
| Primary ethnic origins: | English-Polish |
Siblings:
| # Brothers | 1 |
| # Sisters | 1 |
Other:
| Languages | English |
| Religion | Catholic |
Military
| Branch | Navy |
| Rank | Seaman |
| Service Yrs | 5 |
Mother's Mother
Education
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
| Occupation: | Restaurant worker |
| Primary ethnic origins: | Catholic |
Siblings:
| # Brothers | 0 |
| # Sisters | 1 |
Other:
| Languages | English |
| Religion | Catholic |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |