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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:		Guitar - 10
Other talents:
Years of experience		Juggling - 12
Favorite:
ColorRed
FoodChipotle salmon roll
MusicCollege rock
AnimalPenguin
PetCat
CarMustang
MovieAmerican Beauty
Song"Chasing Cars" from Snow Patrol
PlayDeath of a Salesman
Goals:
AcademicMedical Doctorate
Professional Medical Doctor
PersonalLive to work and not the other way around
Religion:
Faith Christian
Denomination Lutheran
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Sports:
PlayFootball, Softball
WatchFootball
Siblings:
# Brothers3
# Sisters0
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		1250 - out of 1600
ACT
on scale of		31 - 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		ASVAB - 98
High School
Question Response on scale of
GPA
on scale of 		4.24.0
College
Question Response on scale of
GPA
on scale of 		2.64.0
Graduate School
Question Response on scale of
GPA
on scale of 		N/A
Subjects Studied:
Major subjectsPsychology
Minor subjectsBiology and Theatre
Degrees
Bachelor'sPursuing BA/Psychology
Master'sN/A
DoctorateN/A
Other(s)N/A
Awards & Activities
High schoolHonors graduate, Student council, Letter award in multiple sports, Drama club
CollegeFraternity
AcademicPre-med club
Professional Emergency Medical Technician
Political N/A
Personal Boy Scouts of America Eagle Scout
Charitable N/A
OthersN/A

Military

Served in militaryYes
BranchArmy National Guard
RankStaff Sergeant
Years of service5

Physical Features

HandsRight-Handed
FingersMedium
Sizes & Measurements
Neck (inches)17
Chest (inches)44
Inseam (inches)31
Waist (inches)36
Sleeve (inches)29
Wrist (inches)6
Hat size7.5
Shoe size12

Physical Aids

Eyes:
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts0
Laser surgery?No
Dental:
DeviceBraces
ReasonCosmetic
Age range during use12-14
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
OccupationTechnician
Donor's Father Education:
LevelTrade school
DegreeAssociate
SubjectElectronics
Donor's Father Religion:
Faith Christian
Denomination Catholic
Primary ethnic origins:Swedish
Donor's Father Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Donor's Father Talents:
VoiceBaritone
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Father Physical Information
Body
Age55
Height5'11"
Weight190 lbs.
HandsRight-Handed
Donor's Father Facial Features
Eyes:
Eye ColorBrown
Eye shadeMedium
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts
yrs		0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeStraight
Skin:
Skin ToneLight
Skin ConditionDry
Other:
Chin cleftSlight
Ear lobeAttached
Facial DimplesNone
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of service0
Donor's Mother Personal Information
Occupation Technician
Donor's Mother Education:
LevelTrade school
DegreeAssociate
SubjectElectronics
Donor's Mother Religion:
Faith Christian
Denomination Lutheran
Primary ethnic origins:Swedish
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
Age47
Height5'4"
Weight230 lbs.
HandsRight-Handed
Facial Features
Eyes:
Eye ColorBrown
Eye shadeDark
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts
yrs		0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeStraight
Skin:
Skin ToneLight
Skin ConditionOily
Other:
Chin cleftMedium
Ear lobeAttached
Facial DimplesNone
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of service0
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
Full/Half siblingFull
Sibling #1 Physical Information
Body
SexMale
Age23
Height6'4"
Weight195 lbs.
HandsRight-Handed
Sibling #1 Personal Information
Occupation Personal Care Attendant
Education:
LevelCollege
DegreePursuing
SubjectSociology
Religion:
Faith Christian
Denomination Lutheran
Languages:
SpeakEnglish, Spanish
ReadEnglish, Spanish
WriteEnglish, Spanish
Talents:
VoiceBaritone
Instrument
Years of experience		Guitar, Drums - 14, 14
Other
Years of experience		None
Sibling #1 Children:
# Boys
Ages:		0
# Girls
Ages:		0
Sibling #1 Facial Features
Eyes:
Eye colorGreen
Eye shadeLight
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeStraight
Skin:
Skin toneLight
Skin conditionMedium
Other:
Chin cleftMedium
Ear lobeAttached
Facial dimplesNone
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Donor's Sibling #2
Full/Half siblingFull
Sibling #2 Physical Information
Body
SexMale
Age21
Height6'2"
Weight190 lbs.
HandsRight-Handed
Sibling #2 Personal Information
Occupation Student
Education:
LevelSome college
DegreePursuing
SubjectGeneral Studies
Religion:
Faith None
Denomination None
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceBaritone
Instrument
Years of experience		Bass guitar - 10
Other
Years of experience		None
Sibling #2 Children:
# Boys
Ages:		0
# Girls
Ages:		0
Sibling #2 Facial Features
Eyes:
Eye colorBrown
Eye shadeMedium
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeCurly
Skin:
Skin toneLight
Skin conditionMedium
Other:
Chin cleftSlight
Ear lobeAttached
Facial dimplesSlight
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Donor's Sibling #3
Full/Half siblingFull
Sibling #3 Physical Information
Body
SexMale
Age18
Height5'10"
Weight190 lbs.
HandsRight-Handed
Sibling #3 Personal Information
Occupation Student
Education:
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Religion:
Faith None
Denomination None
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceBaritone
Instrument
Years of experience		Guitar - 7
Other
Years of experience		None
Sibling #3 Children:
# Boys
Ages:		0
# Girls
Ages:		0
Sibling #3 Facial Features
Eyes:
Eye colorBrown
Eye shadeMedium
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeStraight
Skin:
Skin toneLight
Skin conditionCombination
Other:
Chin cleftMedium
Ear lobeAttached
Facial dimplesDeep
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Father's Siblings
Father's Brothers
# of Brothers1
Ages of Brothers:66
Education levels for each:Technical college
Occupations for each:Technical Assembly
Religions for each:Catholic
Father's Brothers' Total Children:
# Boys1
# Girls0
Father's Sisters
# of Sisters1
Ages of Sisters:62
Education levels for each:High school
Occupations for each:Teacher
Religions for each:Catholic
Father's Sisters' Total Children:
# Boys0
# Girls3
Mother's Siblings
Mother's Brothers
# Brothers3
Ages of Brothers:52, 50, 45
Education levels for each:All Technical college
Occupations for each:All Technicians
Religions for each:All Lutheran
Mother's Brothers' Total Children:
# Boys2
# Girls2
Mother's Sisters
# Sisters1
Ages of Sisters:44
Education levels for each:Bachelor's
Occupations for each:Health care
Religions for each:Lutheran
Mother's Sisters' Total Children:
# Boys2
# Girls1
Father's Parents
Father's Father
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Technician
Primary ethnic origins:Swedish
Siblings:
# Brothers2
# Sisters1
Other:
LanguagesEnglish
ReligionCatholic
Military
BranchMarine Corps
RankLance Corporal
Service Yrs5
Father's Mother
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Homemaker
Primary ethnic origins:Swedish
Siblings:
# Brothers0
# Sisters0
Other:
LanguagesEnglish
ReligionCatholic
Military
BranchNone
RankN/A
Service Yrs0
Mother's Parents
Mother's Father
Education
LevelSome college
DegreeNot completed
SubjectGeneral Studies
Occupation:Technician
Primary ethnic origins:Swedish
Siblings:
# Brothers2
# Sisters0
Other:
LanguagesEnglish
ReligionLutheran
Military
BranchN/A
RankN/A
Service Yrs0
Mother's Mother
Education
LevelCollege
DegreeAssociate's
SubjectEducation
Occupation:Teacher
Primary ethnic origins:Swedish
Siblings:
# Brothers1
# Sisters0
Other:
LanguagesEnglish
ReligionLutheran
Military
BranchN/A
RankN/A
Service Yrs0