Questions
Personal Information
Talents:
Voice: | Bass |
Tell us about your interests/talents and how long you have been pursuing. Provide several. | Physical fitness training, Motivating others, Home designing |
Favorite:
Color | Blue |
Food | Pork BBQ |
Music | Large variety: Contemporary, Hip Hop, Country, Pop |
Animal | Tiger |
Pet | Dog |
Car | Ford Expedition Max |
Movie | Saving Private Ryan |
Song | Kip Moore- Wild World |
Goals:
Academic | Become a specialist in Orthopedics (OCS) |
Professional | Become a Clinical Director |
Personal | Build a lakehouse, sit back and watch the kids have a good time |
Religion:
Faith | Christian |
Denomination | Non-denominational |
Languages:
Speak | English |
Sports:
Play | Basketball |
Watch | Basketball, Football, Softball, CrossFit |
Siblings:
Are you or any of your siblings twins? Please specify who and if they are fraternal or identical | No |
Academics
Standard Test Score: provide score or denote N/A if not taken
SAT on scale of | N/A - N/A |
ACT on scale of | N/A - N/A |
GRE on scale of | N/A - N/A |
MCAT on scale of | N/A - N/A |
LSAT on scale of | N/A - N/A |
GMAT on scale of | N/A - N/A |
TOEFL on scale of | N/A - N/A |
Other on scale of | N/A - N/A |
High School
Question | Response | on scale of |
GPA on scale of | 3.6 | 4.0 |
College
Question | Response | on scale of |
GPA on scale of | 3.32 | 4.0 |
Graduate School
Question | Response | on scale of |
GPA on scale of | 3.25 | 4.0 |
Subjects Studied:
Major subjects | Biology (BS), Physical Therapy (DPT) |
Minor subjects | N/A |
Degrees
Bachelor's | BS Biology |
Master's | N/A |
Doctorate | DPT (Doctor of Physical Therapy) |
Other(s) | N/A |
Awards & Activities
High school | MVP award (Senior); Most Improved Player (Junior); Set school record for single-game rebounds; All-Tournament Team; Five-Star Camp all-star, Class of 1978 Award. |
College | All Academic Team, Honor Roll Student, At large member of the Student Athlete Advisor Committee, Biology and Histology Tutor |
Academic | Professional Writing Award |
Professional | N/A |
Political | N/A |
Personal | N/A |
Charitable | Walk for Parkinson’s, Wellness Expo, Medical Team at 4K, Event staff “Night to Shine by the Tim Tebow Foundation” |
Others | N/A |
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) | 18 |
Chest (inches) | 49 |
Inseam (inches) | 36 |
Waist (inches) | 39 |
Sleeve (inches) | 37 |
Hat size | 7 ½ |
Shoe size | 14 |
Physical Aids
Eyes:
Vision | Normal |
Glasses | None |
Astigmatism | No |
Age started wearing glasses/contacts | N/A |
Laser surgery? | No |
Dental:
Device | None |
Reason | N/A |
Age range during use | N/A |
Other Physical Aids:
List | N/A |
Reason/cause | N/A |
Facial Features
Eyes:
Set |
|
Size |
|
Shape |
|
Color |
|
Shade |
|
Eyebrows:
Arch |
|
Thickness |
|
Set |
|
Nose:
Size |
|
Shape |
|
Width |
|
Length |
|
Bridge |
|
Nostril flare |
|
Cheekbones:
Set |
|
Mouth:
Size |
|
Lips |
|
Turn |
|
Teeth:
Size |
|
Set |
|
Gap | Yes |
Condition |
|
Chin:
Shape |
|
Prominence |
|
Cleft |
|
Ears:
Size |
|
Set |
|
Angle |
|
Lobe size |
|
Lobe attachment |
|
Hair:
Color at birth |
|
Natural color in adulthood |
|
Shade |
|
Type |
|
Fullness |
|
Texture |
|
Skin:
Tone More about skin tones |
|
Tan ability |
|
Condition |
|
Hairline:
Forehead |
|
Contour |
|
Other Facial Features:
Moles |
|
Freckles |
|
Dimples |
|
Adam's apple |
|
Facial Hair
Thickness |
|
Color |
|
Shade |
|
Family Information
Donor's Parents
Donor's Father Personal Information
Occupation | Educational Center Supervisor |
Donor's Father Education:
Level | College |
Degree | Bachelor |
Subject | Computer Science |
Donor's Father Religion:
Faith | Christian |
Denomination | Non-denominational |
Donor's Father Languages:
Speak | English |
Donor's Father Talents:
Voice | Baritone |
Instrument | N/A |
Other | N/A |
Donor's Father Physical Information
Body
Age | 62 |
Height | 5’6" |
Weight | 165 lbs. |
Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
Eye Color | Brown |
Eye shade | Dark |
Corrective Lenses | No |
Hair:
Original hair color | Black |
Type | Straight |
Skin:
Skin Tone More about skin tones | Espresso |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial Dimples | None |
Donor's Mother Personal Information
Occupation | Retired Medical Coder |
Donor's Mother Education:
Level | College |
Degree | Associate |
Subject | Health Sciences |
Donor's Mother Religion:
Faith | Christian |
Denomination | Non-denominational |
Donor's Mother Languages:
Speak | English |
Donor's Mother Talents:
Voice | Alto |
Instrument | N/A |
Other | N/A |
Donor's Mother Physical Information
Body
Age | 57 |
Height | 5’6" |
Weight | 220 lbs. |
Hands | Right-Handed |
Facial Features
Eyes:
Eye Color | Brown |
Eye shade | Dark |
Corrective Lenses | No |
Hair:
Original hair color | Black |
Type | Curly |
Skin:
Skin Tone More about skin tones | Almond |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial Dimples | Slight |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
Full/Half sibling | Full |
Sibling #1 Physical Information
Body
Age | 31 |
Height | 5’ 9" |
Weight | 195 |
Hands | Right-Handed |
Sibling #1 Personal Information
Occupation | Special Education Para Professional |
Education:
Level | College |
Degree | Bachelor |
Subject | Psychology |
Languages:
Speak | English |
Talents:
Voice | Soprano |
Instrument | N/A |
Other | N/A |
Sibling #1 Children:
# Boys Ages: | 0 |
# Girls Ages: | 0 |
Sibling #1 Facial Features
Eyes:
Eye color | Brown |
Eye shade | Dark |
Corrective Lenses | Yes |
Hair:
Original hair color | Black |
Type | Straight |
Skin:
Skin tone More about skin tones | Beige |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial dimples | Slight |
Donor's Sibling #2
Full/Half sibling | Full |
Sibling #2 Physical Information
Body
Age | 24 |
Height | 5’8" |
Weight | 150 |
Hands | Right-Handed |
Sibling #2 Personal Information
Occupation | Middle School Teacher |
Education:
Level | College |
Degree | Bachelor |
Subject | Biology |
Languages:
Speak | English |
Talents:
Voice | Soprano |
Instrument | N/A |
Other | N/A |
Sibling #2 Children:
# Boys Ages: | 0 |
# Girls Ages: | 0 |
Sibling #2 Facial Features
Eyes:
Eye color | Brown |
Eye shade | Dark |
Corrective Lenses | No |
Hair:
Original hair color | Black |
Type | Curly |
Skin:
Skin tone More about skin tones | Almond |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial dimples | None |
Father's Siblings
Father's Brothers
# of Brothers | 3 |
Ages of Brothers: | 65, 55, 50 |
Education levels for each: | College, High School, College |
Occupations for each: | Teacher, Land Surveyor, Postal Supervisor |
Father's Brothers' Total Children:
# Boys | 3 |
# Girls | 3 |
Father's Sisters
# of Sisters | 2 |
Ages of Sisters: | 57, 55 |
Education levels for each: | College, College |
Occupations for each: | Teacher, Teacher |
Father's Sisters' Total Children:
# Boys | 2 |
# Girls | 1 |
Mother's Siblings
Mother's Brothers
# Brothers | 2 |
Ages of Brothers: | 75, 62 |
Education levels for each: | College, College |
Occupations for each: | Radiologist, Respiratory Therapist |
Mother's Brothers' Total Children:
# Boys | 2 |
# Girls | 2 |
Mother's Sisters
# Sisters | 3 |
Ages of Sisters: | 72, 70, 67 |
Education levels for each: | Trade School, High School, College |
Occupations for each: | Nurse, Legal Administrator, Medical Biller |
Mother's Sisters' Total Children:
# Boys | 1 |
# Girls | 1 |
Father's Parents
Father's Father
Education
Level | High school diploma |
Degree | Other |
Occupation: | Overseas government employee |
Siblings:
# Brothers | 4 |
# Sisters | 3 |
Other:
Languages | English |
Religion | Christian |
Father's Mother
Education
Level | High school diploma |
Degree | Other |
Occupation: | Deaconess, Notary |
Siblings:
# Brothers | 3 |
# Sisters | 3 |
Other:
Languages | English |
Religion | Christian |
Mother's Parents
Mother's Father
Education
Level | High school diploma |
Degree | Other |
Occupation: | Hospital Security Guard, Police officer |
Siblings:
# Brothers | 3 |
# Sisters | 3 |
Other:
Languages | English |
Religion | Christian |
Mother's Mother
Education
Level | High school diploma |
Degree | Other |
Occupation: | Deaconess |
Siblings:
# Brothers | 3 |
# Sisters | 2 |
Other:
Languages | English |
Religion | Christian |