Questions

Academics
Military
Physical Features
Physical Aids
Facial Features
Family Information
Donor's Parents
Father's Siblings
Mother's Siblings
Father's Parents
Mother's Parents

Personal Information

Talents:
Voice:Baritone
Instrument:
Years of experience:		None
Other talents:
Years of experience		None
Favorite:
ColorRed
FoodPizza
MusicRap
AnimalNone
PetNone
CarCamaro
MoviePlatoon
SongI Ain't Mad at Cha
PlayA Raisin in the Sun
Goals:
AcademicMaster's degree
Professional Self-employment
PersonalGet married and have a family
Religion:
Faith Islam
Denomination N/A
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Sports:
PlayNone
WatchBasketball
Siblings:
# BrothersN/A
# SistersN/A
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		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 		3.05.0
College
Question Response on scale of
GPA
on scale of 		2.594.0
Graduate School
Question Response on scale of
GPA
on scale of 		N/A
Subjects Studied:
Major subjectsRespiratory Therapy
Minor subjectsN/A
Degrees
Bachelor'sBS/Respiratory Therapy
Master'sN/A
DoctorateN/A
Other(s)AA/Respiratory Therapy
Awards & Activities
High schoolPlayed football
CollegeN/A
AcademicN/A
Professional Member of a professional organization
Political N/A
Personal N/A
Charitable N/A
OthersN/A

Military

Served in militaryYes
BranchUnited States Marine Corps
RankPrivate First Class
Years of service2

Physical Features

HandsRight-Handed
FingersMedium
Sizes & Measurements
Neck (inches)16
Chest (inches)42
Inseam (inches)34
Waist (inches)36
Sleeve (inches)32
Wrist (inches)6
Hat size7
Shoe size14

Physical Aids

Eyes:
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contactsN/A
Laser surgery?No
Dental:
DeviceBraces
ReasonCosmetic
Age range during use29-present
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
OccupationFull-time Student
Donor's Father Education:
LevelCollege
DegreePursuing
SubjectGeneral Studies
Donor's Father Religion:
Faith Christian
Denomination Non-denominational
Primary ethnic origins:Nigerian
Donor's Father Languages:
SpeakEnglish, Ibo
ReadEnglish, Ibo
WriteEnglish
Donor's Father Talents:
VoiceN/A - (Unknown)
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Father Physical Information
Body
Age27 - (Deceased)
Height6'2"
Weight190 lbs.
HandsRight-Handed
Donor's Father Facial Features
Eyes:
Eye ColorBrown
Eye shadeMedium
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts
yrs		N/A
Hair:
Original hair color Black
If gray, age turned grayN/A
TypeCurly
Skin:
Skin ToneDark
Skin ConditionMedium
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 Certified Nursing Assistant
Donor's Mother Education:
LevelCollege
DegreeOther
SubjectNursing Assistant Certificate
Donor's Mother Religion:
Faith Christian
Denomination Baptist
Primary ethnic origins:Nigerian
Donor's Mother Languages:
SpeakEnglish, Ibo
ReadEnglish
WriteEnglish
Donor's Mother Talents:
VoiceAlto
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Mother Physical Information
Body
Age57
Height5'3"
Weight150 lbs.
HandsRight-Handed
Facial Features
Eyes:
Eye ColorBrown
Eye shadeMedium
Vision Near-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts
yrs		50
Hair:
Original hair color Black
If gray, age turned gray50
TypeCurly
Skin:
Skin ToneMed
Skin ConditionOily
Other:
Chin cleftNone
Ear lobeAttached
Facial DimplesNone
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of serviceN/A
Father's Siblings
Father's Brothers
# of Brothers1
Ages of Brothers:66
Education levels for each:Master's
Occupations for each:Engineer (retired)
Religions for each:Christian
Father's Brothers' Total Children:
# Boys1
# Girls1
Father's Sisters
# of Sisters1
Ages of Sisters:57
Education levels for each:Bachelor's
Occupations for each:Accountant (retired)
Religions for each:Christian
Father's Sisters' Total Children:
# Boys1
# Girls1
Mother's Siblings
Mother's Brothers
# Brothers1
Ages of Brothers:68
Education levels for each:Some college
Occupations for each:Bank Teller (retired)
Religions for each:Christian
Mother's Brothers' Total Children:
# Boys2
# Girls1
Mother's Sisters
# Sisters3
Ages of Sisters:63, 59, 55
Education levels for each:Some high school, High school, High school
Occupations for each:Unknown (all)
Religions for each:Christian (all)
Mother's Sisters' Total Children:
# Boys2
# Girls2
Father's Parents
Father's Father
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Mechanic
Primary ethnic origins:Nigerian
Siblings:
# Brothers2
# Sisters2
Other:
LanguagesIbo, English
ReligionChristian
Military
BranchN/A
RankN/A
Service YrsN/A
Father's Mother
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Homemaker
Primary ethnic origins:Nigerian
Siblings:
# Brothers1
# Sisters2
Other:
LanguagesIbo, English
ReligionChristian
Military
BranchN/A
RankN/A
Service YrsN/A
Mother's Parents
Mother's Father
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Farmer
Primary ethnic origins:Nigerian
Siblings:
# Brothers3
# Sisters2
Other:
LanguagesIbo, English
ReligionChristian
Military
BranchN/A
RankN/A
Service YrsN/A
Mother's Mother
Education
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Occupation:Homemaker
Primary ethnic origins:Nigerian
Siblings:
# Brothers2
# Sisters1
Other:
LanguagesIbo, English
ReligionChristian
Military
BranchN/A
RankN/A
Service YrsN/A