Questions
Personal Information
Talents:
Voice: | Baritone |
Instrument: Years of experience: | None |
Other talents: Years of experience | Computer gaming - 7 |
Favorite:
Color | Midnight blue |
Food | Indian |
Music | Alternative Rock |
Animal | Koala bear |
Pet | Cat |
Car | 1967 Chevrolet Camaro SS |
Movie | "The Life of David Gale" |
Song | "Given to Fly" by Pearl Jam |
Play | "Romeo and Juliet" |
Goals:
Academic | Attend medical school |
Professional | Become a very good cardiologist |
Personal | Be happy, true to myself, and enjoy life |
Religion:
Faith | Other |
Denomination | Agnostic |
Languages:
Speak | English, Japanese |
Read | English, Japanese |
Write | English |
Sports:
Play | Football, Ultimate frisbee, Racquetball |
Watch | Football, Basketball |
Siblings:
# Brothers | 1 |
# Sisters | 1 |
Are you a twin? Identical or fraternal? | No |
# of twins in your family | 0 |
# Identical sets | 0 |
# Fraternal sets | 0 |
Academics
Standard Test Score: provide score or denote N/A if not taken
SAT on scale of | Math: 720; Verbal: 610 |
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 | 3.40 | 4.00 |
College
Question | Response | on scale of |
GPA on scale of | 3.93 | 4.00 |
Graduate School
Question | Response | on scale of |
GPA on scale of | N/A | N/A |
Subjects Studied:
Major subjects | Calculus, Genetics, Organic Chemistry, Cell Biology, Neurophysiology, Physics, Biochemistry |
Minor subjects | Quantum Chemistry, Japanese (language), Differential Equations, Physical Chemistry |
Degrees
Bachelor's | BS Neurobiology |
Master's | N/A |
Doctorate | Pursuing MD, Neurobiology |
Other(s) | N/A |
Awards & Activities
High school | Advanced placement honors |
College | Honors |
Academic | Research grant |
Professional | N/A |
Political | N/A |
Personal | None |
Charitable | None |
Others | None |
Military
Served in military | No |
Branch | N/A |
Rank | N/A |
Years of service | 0 |
Physical Features
Hands | Right-Handed |
Fingers | Medium |
Sizes & Measurements
Neck (inches) | 14 |
Chest (inches) | 36 |
Inseam (inches) | 32 |
Waist (inches) | 30 |
Sleeve (inches) | 31 |
Wrist (inches) | 7 |
Hat size | 7 |
Shoe size | 11 |
Physical Aids
Eyes:
Vision | Normal |
Glasses | None |
Astigmatism | No |
Age started wearing glasses/contacts | 0 |
Laser surgery? | No |
Dental:
Device | None |
Reason | N/A |
Age range during use | N/A |
Other Physical Aids:
List | None |
Reason/cause | N/A |
Facial Features
Eyes:
Set |
|
Size |
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Shape |
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Color |
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Shade |
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Eyebrows:
Arch |
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Thickness |
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Set |
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Nose:
Size |
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Shape |
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Width |
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Length |
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Bridge |
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Nostril flare |
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Septum |
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Cheekbones:
Set |
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Prominence |
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Mouth:
Size |
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Lips |
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Turn |
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Teeth:
Size |
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Set |
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Condition |
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Chin:
Shape |
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Prominence |
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Cleft |
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Ears:
Size |
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Set |
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Angle |
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Lobe size |
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Lobe attachment |
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Hair:
Color at birth |
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Natural color in adulthood |
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Shade |
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Type |
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Fullness |
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Texture |
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Skin:
Tone |
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Tan ability |
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Condition |
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Hairline:
Forehead |
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Contour |
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Other Facial Features:
Moles |
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Freckles |
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Dimples |
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Adam's apple |
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Facial Hair
Thickness |
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Shade |
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Family Information
Donor's Parents
Donor's Father Personal Information
Occupation | Professional Engineer |
Donor's Father Education:
Level | Graduate school |
Degree | Master |
Subject | Chemical Engineering |
Donor's Father Religion:
Faith | Christian |
Denomination | Baptist |
Primary ethnic origins: | Dutch |
Donor's Father Languages:
Speak | English, German |
Read | English |
Write | English |
Donor's Father Talents:
Voice | Baritone |
Instrument yrs experience | None |
Other yrs experience | Technology and Mechanical hobbies - 30 |
Donor's Father Physical Information
Body
Age | 55 |
Height | 6'0" |
Weight | 190 lbs |
Hands | Ambidextrous |
Donor's Father Facial Features
Eyes:
Eye Color | Brown |
Eye shade | Medium |
Vision | Far-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts yrs | 49 |
Hair:
Original hair color | Brown |
If gray, age turned gray | N/A |
Type | Straight |
Skin:
Skin Tone | MedDk |
Skin Condition | Combination |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial Dimples | None |
Military
Served in Military | No |
Branch | N/A |
Rank | N/A |
Years of service | 0 |
Donor's Mother Personal Information
Occupation | Registered Nurse |
Donor's Mother Education:
Level | College |
Degree | Bachelor |
Subject | Nursing |
Donor's Mother Religion:
Faith | Christian |
Denomination | Baptist |
Primary ethnic origins: | Kickapoo (Native American)-French |
Donor's Mother Languages:
Speak | English |
Read | English |
Write | English |
Donor's Mother Talents:
Voice | Alto |
Instrument yrs experience | None - N/A |
Other yrs experience | Cooking - 35 |
Donor's Mother Physical Information
Body
Age | 51 |
Height | 5'0" |
Weight | 220 lbs |
Hands | Right-Handed |
Facial Features
Eyes:
Eye Color | Brown |
Eye shade | Medium |
Vision | Far-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts yrs | 49 |
Hair:
Original hair color | Auburn |
If gray, age turned gray | 48 |
Type | Straight |
Skin:
Skin Tone | MedL |
Skin Condition | Combination |
Other:
Chin cleft | Slight |
Ear lobe | Attached |
Facial Dimples | Medium |
Military
Served in Military | No |
Branch | N/A |
Rank | N/A |
Years of service | 0 |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
Full/Half sibling | Full |
Sibling #1 Physical Information
Body
Sex | Male |
Age | 23 |
Height | 5'11" |
Weight | 170 lbs |
Hands | Left-Handed |
Sibling #1 Personal Information
Occupation | Student |
Education:
Level | College |
Degree | Pursuing |
Subject | Accounting |
Religion:
Faith | None |
Denomination | N/A |
Languages:
Speak | English, Spanish |
Read | English, Spanish |
Write | English |
Talents:
Voice | Tenor |
Instrument Years of experience | None |
Other Years of experience | Artistic drawing - 10 |
Sibling #1 Children:
# Boys Ages: | None |
# Girls Ages: | None |
Sibling #1 Facial Features
Eyes:
Eye color | Blue |
Eye shade | Light |
Vision | Near-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts | 12 |
Hair:
Original hair color | Blond |
If gray, age turned gray | N/A |
Type | Straight |
Skin:
Skin tone | MedL |
Skin condition | Combination |
Other:
Chin cleft | None |
Ear lobe | Attached |
Facial dimples | Medium |
Military
Served in military | No |
Branch | N/A |
Rank | N/A |
Years of service | 0 |
Donor's Sibling #2
Full/Half sibling | Full |
Sibling #2 Physical Information
Body
Sex | Female |
Age | 25 |
Height | 5'4" |
Weight | 105 lbs |
Hands | Right-Handed |
Sibling #2 Personal Information
Occupation | Student |
Education:
Level | Graduate school |
Degree | Pursuing |
Subject | Medicine |
Religion:
Faith | Christian |
Denomination | Baptist |
Languages:
Speak | English, Spanish |
Read | English, Spanish |
Write | English |
Talents:
Voice | Alto |
Instrument Years of experience | None |
Other Years of experience | Writing - 7 |
Sibling #2 Children:
# Boys Ages: | None |
# Girls Ages: | None |
Sibling #2 Facial Features
Eyes:
Eye color | Brown |
Eye shade | Medium |
Vision | Far-Sighted |
Glasses | Single |
Astigmatism | No |
Age started wearing glasses/contacts | 20 |
Hair:
Original hair color | Brown |
If gray, age turned gray | N/A |
Type | Straight |
Skin:
Skin tone | Med |
Skin condition | Combination |
Other:
Chin cleft | None |
Ear lobe | Detached |
Facial dimples | Slight |
Military
Served in military | No |
Branch | N/A |
Rank | N/A |
Years of service | 0 |
Father's Siblings
Father's Brothers
# of Brothers | 1 |
Ages of Brothers: | 50 |
Education levels for each: | College |
Occupations for each: | Unknown (estranged) |
Religions for each: | Unknown (estranged) |
Father's Brothers' Total Children:
# Boys | 0 - Unknown (estranged) |
# Girls | 0 - Unknown (estranged) |
Father's Sisters
# of Sisters | 1 |
Ages of Sisters: | 52 |
Education levels for each: | College |
Occupations for each: | Teacher |
Religions for each: | Christian |
Father's Sisters' Total Children:
# Boys | 1 |
# Girls | 2 |
Mother's Siblings
Mother's Brothers
# Brothers | 1 |
Ages of Brothers: | 50 |
Education levels for each: | College |
Occupations for each: | Contractor |
Religions for each: | Christian |
Mother's Brothers' Total Children:
# Boys | 1 |
# Girls | 1 |
Mother's Sisters
# Sisters | 3 |
Ages of Sisters: | 56, 55, 49 |
Education levels for each: | College for all |
Occupations for each: | Nurse, Stewardess, Realtor |
Religions for each: | Christian for all |
Mother's Sisters' Total Children:
# Boys | 1 |
# Girls | 2 |
Father's Parents
Father's Father
Education
Level | High school |
Degree | Diploma |
Subject | Shop/building type classes |
Occupation: | Electrician |
Primary ethnic origins: | Dutch |
Siblings:
# Brothers | 1 |
# Sisters | 1 |
Other:
Languages | German, English |
Religion | Christian |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | 0 - N/A |
Father's Mother
Education
Level | High school |
Degree | Diploma |
Subject | General studies |
Occupation: | Teacher |
Primary ethnic origins: | Dutch |
Siblings:
# Brothers | 3 |
# Sisters | 0 |
Other:
Languages | English |
Religion | Christian |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | 0 - N/A |
Mother's Parents
Mother's Father
Education
Level | High school |
Degree | Diploma |
Subject | General studies |
Occupation: | Electrician |
Primary ethnic origins: | Kickapoo (Native American)-French |
Siblings:
# Brothers | 1 |
# Sisters | 0 - 0 |
Other:
Languages | English |
Religion | Christian |
Military
Branch | Navy |
Rank | Unknown (enlisted personnel) |
Service Yrs | 4 |
Mother's Mother
Education
Level | High school |
Degree | Diploma |
Subject | General studies |
Occupation: | Housewife |
Primary ethnic origins: | Kickapoo (Native American) |
Siblings:
# Brothers | 2 |
# Sisters | 2 |
Other:
Languages | English |
Religion | Christian |
Military
Branch | N/A |
Rank | N/A |
Service Yrs | 0 |