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Questions

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

Personal Information

Talents:
Voice:Bass
Instrument:
Years of experience:		Guitar - 1
Other talents:
Years of experience		Creative writing - 9
Favorite:
ColorFire engine red
FoodEnchiladas
Music80's Classic rock
AnimalCat
PetCat
CarDodge Challenger
MovieThe Shawshank Redemption
Song"Fly by Night" by Rush
Play"Shop Girl"
Goals:
AcademicParamedic or Fire Technology degree
Professional Fire officer
PersonalHappiness
Religion:
Faith Christian
Denomination Catholic
Languages:
SpeakEnglish, Spanish
ReadEnglish, Spanish
WriteEnglish, Spanish
Sports:
PlayRunning, Football, Wrestling,Track
WatchCollege football
Siblings:
# Brothers2
# Sisters3
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 		3.564.00
College
Question Response on scale of
GPA
on scale of 		3.744.00
Graduate School
Question Response on scale of
GPA
on scale of 		N/A
Subjects Studied:
Major subjectsEMT/Firefighter
Minor subjectsLife Span Development
Degrees
Bachelor'sN/A
Master'sN/A
DoctorateN/A
Other(s)EMT and Firefighter Certification
Awards & Activities
High schoolFootball, Wrestling, Track
CollegeSalutatorian
AcademicSalutatorian
Professional Firefighter, Driver/Operator, EMT Certified
Political None
Personal None
Charitable Donate to MDA (Muscular Dystrophy Association) yearly
OthersArmy awards, medal, leadership achievements

Military

Served in militaryYes
BranchArmy
RankCorporal
Years of service4

Physical Features

HandsRight-Handed
FingersLong
Sizes & Measurements
Neck (inches)16.5
Chest (inches)42
Inseam (inches)34
Waist (inches)38
Sleeve (inches)32
Wrist (inches)7.5
Hat size7.5
Shoe size13

Physical Aids

Eyes:
Vision Normal
GlassesNone
AstigmatismYes
Age started wearing glasses/contacts0
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
OccupationMaintenance
Donor's Father Education:
LevelHigh school
DegreeDiploma
SubjectGeneral studies
Donor's Father Religion:
Faith None
Denomination N/A
Primary ethnic origins:English
Donor's Father Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Donor's Father Talents:
VoiceBass
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Father Physical Information
Body
Age78
Height5'10"
Weight170 lbs
HandsRight-Handed
Donor's Father Facial Features
Eyes:
Eye ColorHazel
Eye shadeLight
Vision Far-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts
yrs		50
Hair:
Original hair color Brown
If gray, age turned gray55
TypeStraight
Skin:
Skin ToneMed
Skin ConditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial DimplesNone
Military
Served in MilitaryNo
BranchN/A
RankN/A
Years of service0
Donor's Mother Personal Information
Occupation Childcare
Donor's Mother Education:
LevelCollege
DegreeBachelor
SubjectChild Development
Donor's Mother Religion:
Faith Christian
Denomination Catholic
Primary ethnic origins:Italian-German-Scandinavian
Donor's Mother Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Donor's Mother Talents:
VoiceSoprano
Instrument
yrs experience		None
Other
yrs experience		None
Donor's Mother Physical Information
Body
Age51
Height5'6"
Weight200 lbs.
HandsRight-Handed
Facial Features
Eyes:
Eye ColorBrown
Eye shadeMedium
Vision Far-Sighted
GlassesSingle
AstigmatismNo
Age started wearing glasses/contacts
yrs		18
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeWavy
Skin:
Skin ToneMed
Skin ConditionMedium
Other:
Chin cleftNone
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
Age30
Height6'0"
Weight290 lbs.
HandsRight-Handed
Sibling #1 Personal Information
Occupation Student, Coach
Education:
LevelSome college
DegreeDiploma
SubjectEducation
Religion:
Faith Christian
Denomination Catholic
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceBass
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 Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeStraight
Skin:
Skin toneMed
Skin conditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial dimplesNone
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Donor's Sibling #2
Full/Half siblingHalf
Sibling #2 Physical Information
Body
SexMale
Age58
Height5'0"
Weight240 lbs.
HandsRight-Handed
Sibling #2 Personal Information
Occupation Realtor
Education:
LevelSome college
DegreeOther
SubjectUnknown
Religion:
Faith None
Denomination N/A
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceBass
Instrument
Years of experience		None
Other
Years of experience		None
Sibling #2 Children:
# Boys
Ages:		1 - 30
# Girls
Ages:		1 - 28
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
TypeStraight
Skin:
Skin toneMed
Skin conditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial dimplesNone
Military
Served in militaryYes
BranchMarine Corp
RankLance Corporal
Years of service6
Donor's Sibling #3
Full/Half siblingHalf
Sibling #3 Physical Information
Body
SexFemale
Age32
Height5'5"
Weight170 lbs.
HandsRight-Handed
Sibling #3 Personal Information
Occupation Waitress
Education:
LevelHigh school
DegreeDiploma
SubjectGeneral studies
Religion:
Faith Christian
Denomination Unknown
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceSoprano
Instrument
Years of experience		None
Other
Years of experience		None
Sibling #3 Children:
# Boys
Ages:		0
# Girls
Ages:		0
Sibling #3 Facial Features
Eyes:
Eye colorBlue
Eye shadeMedium
Vision Normal
GlassesNone
AstigmatismNo
Age started wearing glasses/contacts0
Hair:
Original hair color Brown
If gray, age turned grayN/A
TypeWavy
Skin:
Skin toneMed
Skin conditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial dimplesNone
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Donor's Sibling #4
Full/Half siblingHalf
Sibling #4 Physical Information
Body
SexFemale
Age35
Height5'1"
Weight165 lbs.
HandsRight-Handed
Sibling #4 Personal Information
Occupation Waitress
Education:
LevelHigh school
DegreeDiploma
SubjectGeneral studies
Religion:
Faith Christian
Denomination Unknown
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceSoprano
Instrument
Years of experience		None
Other
Years of experience		None
Sibling #4 Children:
# Boys
Ages:		1 - 16
# Girls
Ages:		2 - 13, 17
Sibling #4 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 toneMedL
Skin conditionMedium
Other:
Chin cleftNone
Ear lobeAttached
Facial dimplesNone
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Donor's Sibling #5
Full/Half siblingHalf
Sibling #5 Physical Information
Body
SexFemale
Age39
Height5'9"
Weight200 lbs.
HandsRight-Handed
Sibling #5 Personal Information
Occupation Telemarketing
Education:
LevelHigh school
DegreeDiploma
SubjectGeneral Studies
Religion:
Faith Christian
Denomination Unknown
Languages:
SpeakEnglish
ReadEnglish
WriteEnglish
Talents:
VoiceSoprano
Instrument
Years of experience		None
Other
Years of experience		None
Sibling #5 Children:
# Boys
Ages:		3 - 10, 12, 17
# Girls
Ages:		0
Sibling #5 Facial Features
Eyes:
Eye colorHazel
Eye shadeLight
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 cleftNone
Ear lobeAttached
Facial dimplesNone
Military
Served in militaryNo
BranchN/A
RankN/A
Years of service0
Father's Siblings
Father's Brothers
# of Brothers4
Ages of Brothers:75, 84, 90, 91
Education levels for each:College, High school, High school, High school
Occupations for each:Geologist, Factory worker, Miner, Truck driver
Religions for each:Christian (all)
Father's Brothers' Total Children:
# Boys4
# Girls2
Father's Sisters
# of Sisters5
Ages of Sisters:75, 80, 85, 90, 92
Education levels for each:High school (all)
Occupations for each:Homemaker (all)
Religions for each:Christian (all)
Father's Sisters' Total Children:
# Boys6
# Girls7
Father's Parents
Father's Father
Education
LevelHigh School
DegreeDiploma
SubjectGeneral studies
Occupation:Miner
Primary ethnic origins:English
Siblings:
# Brothers1
# Sisters1
Other:
LanguagesEnglish
ReligionChristian
Military
BranchNo
RankN/A
Service Yrs0
Father's Mother
Education
LevelHigh school
DegreeDiploma
SubjectGeneral studies
Occupation:Homemaker
Primary ethnic origins:English
Siblings:
# Brothers0
# Sisters0
Other:
LanguagesEnglish
ReligionUnknown
Military
BranchNo
RankN/A
Service Yrs0
Mother's Parents
Mother's Father
Education
LevelSome College
DegreeDiploma
SubjectGeneral studies
Occupation:Business owner
Primary ethnic origins:German
Siblings:
# Brothers1
# Sisters0
Other:
LanguagesEnglish
ReligionProtestant
Military
BranchArmy
RankSergeant
Service Yrs6
Mother's Mother
Education
LevelHigh School
DegreeDiploma
SubjectGeneral studies
Occupation:Administration, retired
Primary ethnic origins:Italian-Scandinavian
Siblings:
# Brothers0
# Sisters3
Other:
LanguagesEnglish
ReligionCatholic
Military
BranchNo
RankN/A
Service Yrs0