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:Baritone
Instrument:
Years of experience:		Guitar - 3
Other talents:
Years of experience		Fast learner - Since childhood
Favorite:
ColorOrange
FoodSloppy Joes
MusicClassic Rock, Punk, Jazz
AnimalPanther
PetDog
CarAMC Eagle, any old station wagon
MovieThe Wizard of Oz
Song"Baba O'Riley" by The Who
PlayNone
Goals:
AcademicGraduate degree
Professional High school teacher
PersonalLearn as much as possible
Religion:
Faith None
Denomination N/A
Languages:
SpeakEnglish, Spanish
ReadEnglish, Spanish
WriteEnglish, Spanish
Sports:
PlayFootball, Basketball, Baseball
WatchFootball
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		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 		3.74.0
College
Question Response on scale of
GPA
on scale of 		3.904.0
Graduate School
Question Response on scale of
GPA
on scale of 		N/A
Subjects Studied:
Major subjectsSociology
Minor subjectsN/A
Degrees
Bachelor'sPursuing BA/Sociology
Master'sN/A
DoctorateN/A
Other(s)N/A
Awards & Activities
High schoolNational History Day Competition
CollegeParticipation in student activism organizations
AcademicDean'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
OthersN/A

Military

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

Physical Features

HandsRight-Handed
FingersMedium
Sizes & Measurements
Neck (inches)16
Chest (inches)39
Inseam (inches)34
Waist (inches)34
Sleeve (inches)33
Wrist (inches)7
Hat size7
Shoe size12

Physical Aids

Eyes:
Vision Near-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts13
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
OccupationCommercial Driver
Donor's Father Education:
LevelSome college
DegreeNot Completed
SubjectHistory/Education
Donor's Father Religion:
Faith Christian
Denomination Presbyterian
Primary ethnic origins:German
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
Age50
Height6'0"
Weight220 lbs.
HandsRight-Handed
Donor's Father Facial Features
Eyes:
Eye ColorGreen
Eye shadeMedium
Vision Near-Sighted
GlassesSingle
AstigmatismYes
Age started wearing glasses/contacts
yrs		16
Hair:
Original hair color Blond
If gray, age turned grayN/A
TypeStraight
Skin:
Skin ToneMedL
Skin ConditionCombination
Other:
Chin cleftNone
Ear lobeAttached
Facial DimplesNone
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of serviceN/A
Donor's Mother Personal Information
Occupation Physical Therapist
Donor's Mother Education:
LevelGraduate school
DegreeMaster
SubjectPhysical Therapy
Donor's Mother Religion:
Faith Christian
Denomination Catholic
Primary ethnic origins:Norwegian
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
Age50
Height5'10"
Weight180 lbs.
HandsRight-Handed
Facial Features
Eyes:
Eye ColorHazel
Eye shadeMedium
Vision Near-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts
yrs		10
Hair:
Original hair color Blond
If gray, age turned grayN/A
TypeStraight
Skin:
Skin ToneLight
Skin ConditionMedium
Other:
Chin cleftSlight
Ear lobeAttached
Facial DimplesNone
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
Age19
Height5'11"
Weight130 lbs.
HandsRight-Handed
Sibling #1 Personal Information
Occupation Student
Education:
LevelSome college
DegreePursuing
SubjectEarly Childhood Education
Religion:
Faith Christian
Denomination Non-denominational
Languages:
SpeakEnglish, Spanish
ReadEnglish, Spanish
WriteEnglish, Spanish
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 colorBlue
Eye shadeMedium
Vision Near-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts15
Hair:
Original hair color Blond
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 serviceN/A
Father's Siblings
Father's Sisters
# of Sisters1
Ages of Sisters:47
Education levels for each:College
Occupations for each:Secretary
Religions for each:Christian
Father's Sisters' Total Children:
# Boys2
# GirlsN/A
Mother's Siblings
Mother's Brothers
# Brothers4
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:
# Boys5
# Girls1
Mother's Sisters
# Sisters2
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:
# Boys1
# Girls4
Father's Parents
Father's Father
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Construction Worker/Business Owner
Primary ethnic origins:German
Siblings:
# Brothers1
# Sisters4
Other:
LanguagesEnglish
ReligionPresbyterian
Military
BranchN/A
RankN/A
Service YrsN/A
Father's Mother
Education
LevelCollege
DegreeBachelor's
SubjectSpecial Education
Occupation:Special Education Teacher
Primary ethnic origins:German
Siblings:
# Brothers1
# Sisters1
Other:
LanguagesEnglish
ReligionCatholic
Military
BranchN/A
RankN/A
Service YrsN/A
Mother's Parents
Mother's Father
Education
LevelCollege
DegreeBachelor's
SubjectPsychology
Occupation:Mental Health Institution Administrator
Primary ethnic origins:Norwegian
Siblings:
# Brothers2
# Sisters1
Other:
LanguagesEnglish, Norwegian
ReligionCatholic
Military
BranchN/A
RankN/A
Service YrsN/A
Mother's Mother
Education
LevelCollege
DegreeBachelor's
SubjectNursing
Occupation:Registered Nurse
Primary ethnic origins:Norwegian
Siblings:
# Brothers1
# Sisters3
Other:
LanguagesEnglish
ReligionCatholic
Military
BranchN/A
RankN/A
Service YrsN/A