personal profile - fairfax cryobank · reading, guitar, exercising, cooking, video games, traveling...

Donor 5013

Personal Profile

QUESTIONS

Academics

Military

Physical Features

Physical Aids, if not applicable, please enter N/A.

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

Musical/Instrument:Years of experience: Guitar ‐ 2

Other talents:Years of experience None

FAVORITE:

Color Blue

Food Pizza

Music Rock

Animal Dog

Pet Dog

Car Honda Civic

Movie Fury

https://fairfaxcryobank.com/search/

Song "I Don't Want to Miss a Thing" by Aerosmith

Play The Wizard of Oz

GOALS:

Academic Associate of Applied Science degree in Nursing

Professional To become a nurse

Personal My personal goal is to finish the Nursing program

RELIGION:

Faith Christian

Denomination Catholic

LANGUAGES:

Speak English

Read English

Write English

SPORTS:

Please enter sports that you play and howlong you have played them. Soccer

Please enter sports that you enjoy watching. Soccer

SIBLINGS:

# Brothers 2

# Sisters 1

Are you a twin?Identical or fraternal? No

# of twins in your family N/A

# Identical sets 0

# Fraternal sets 0

ACADEMICS

STANDARD TEST SCORE: PROVIDE SCORE OR DENOTE N/A IF NOT TAKEN

SATon scale of N/A

ACTon scale of N/A

GREon scale of N/A

MCATon scale of N/A

LSATon scale of

N/A

GMATon scale of N/A

TOEFLon scale of N/A

Otheron scale of N/A

HIGH SCHOOL

QUESTION RESPONSE ON SCALE OF


GPAon scale of

3.0 4.0

COLLEGE



GPAon scale of

2.74 4.0

GRADUATE SCHOOL



GPAon scale of

NA

SUBJECTS STUDIED:

Major subjects Nursing

Minor subjects N/A

PLEASE ENTER THE DEGREE AND SPECIFIC FIELD OF STUDY, E.G. BA BUSINESS.

Bachelor's N/A

Master's N/A

Doctorate N/A

Other(s) Certified Nursing Assistant, Pursuing AAS/Nursing

AWARDS & ACTIVITIES

High school N/A

College Health Science certificate

Academic CPR and First aid certified, Certified NursingAssistant

Professional Two year job award at a medical center

Political N/A

Personal Reading, Guitar, Exercising, Cooking, Video games,Traveling

Charitable N/A

Others N/A

MILITARYServed in military No

Branch N/A

Rank N/A

Years of service 0

PHYSICAL FEATURESHands Ambidextrous

Fingers Long

SIZES & MEASUREMENTS

Neck (inches) 17

Chest (inches) 39

Inseam (inches) 31

Waist (inches) 32

Sleeve (inches) 31

Wrist (inches) 9

Hat size 7

Shoe size 9.5

PHYSICAL AIDS, IF NOT APPLICABLE, PLEASE ENTER N/A.

EYES:

Vision Near‐Sighted

Glasses Single

Astigmatism Yes

Age started wearing glasses/contacts 18

Laser surgery? No

DENTAL:

Device None

Reason

Age range during use N/A

OTHER PHYSICAL AIDS:

List None

Reason/cause N/A

Blue

Green

Hazel

Brown

Light

Medium

Dark

Flat

Medium

High

FACIAL FEATURES

EYES:

Set

Narrow Average Wide

Size

Small Average Large

Shape

Almond Oval Round

Color

Shade

EYEBROWS:

Arc

Thickness

Thin Average Thick

Narrow

Average

Wide

Small

Medium

Large

Narrow

Average

Wide

Short

Average

Long

Small

Average

Wide

Thin

Average

Thick

Low

Average

High

Slight

Medium

Strong

Set

NOSE:

Size

Shape

Round Straight Wide

Width

Length

Bridge

Convex Straight Concave

Nostril flare

Septum

CHEEKBONES:

Set

Prominence

MOUTH:

Downward

Straight

Upward

Underbite

Even

Overbite

Poor

Fair

Good

Slight

Average

Strong

Size

Small Average Large

Lips

Thin Average Full

Turn

TEETH:

Size

Average Large Small

Set

Condition

CHIN:

Shape

Round Oval Square

Prominence

Low

Average

High

Small

Medium

Large

Blond

Brown

Auburn

Red

Black

Blond

Brown

Auburn

Red

Cleft

None Slight Strong

EARS:

Size

Small Average Large

Set

Angle

Flat Average Acute

Lobe size

Lobe attachment

Detached Attached

HAIR:

Color at birth

Natural color in adulthood

Black

Light

Medium

Dark

Straight

Wavy

Curly

Thin

Medium

Thick

Fine

Coarse

Medium

Light

MedL

Med

MedDk

Dark

None

Slight

Medium

Easy

Oily

Medium

Combination

Dry

Low

Average

High

Straight

Slight Curve

Widow Peak

None

One

Several

None

Shade

Type

Fullness

Texture

SKIN:

Tone

Tan ability

Condition

HAIRLINE:

Forehead

Contour

OTHER FACIAL FEATURES:

Moles

Several

Moderate

Numerous

None

Slight

Medium

Deep

Slight

Medium

Strong

Thin

Medium

Dense

Light

Medium

Dark

Freckles

Dimples

Adam's apple

FACIAL HAIR

Thickness

Shade

FAMILY INFORMATION

DONOR'S PARENTS

Donor's Father Personal Information

Occupation Truck Driver

Donor's Father Education:

Level High school

Degree Diploma

Subject General Studies

Donor's Father Religion:

Faith Christian

Denomination Non‐denominational

Primary ethnic origins: German

Donor's Father Languages:

Speak English

Read English

Write English

Donor's Father Talents:

Voice Bass

Instrumentyrs experience None

Otheryrs experience None

Donor's Father Physical Information

Body

Age 56

Height 6'0"

Weight 210 lbs.

Hands Right‐Handed

Donor's Father Facial Features

Eyes:

Eye Color Blue

Eye shade Light

Vision Normal

Glasses None

Astigmatism No

Age started wearing glasses/contactsyrs 0

Hair:

Original hair color Brown

If gray, age turned grayyrs N/A

Type Straight

Skin:

Skin Tone MedL

Skin Condition Medium

Other:

Chin cleft Slight

Ear lobe Attached

Facial Dimples None

Military

Served in Military Yes

Branch Army

Rank Sergeant

Years of service 13

Donor's Mother Personal Information

Occupation Homemaker

Donor's Mother Education:

Level High school

Degree Diploma


Donor's Mother Religion:

Faith Christian


Primary ethnic origins: Panamanian, Palestinian

Donor's Mother Languages:

Speak English, Spanish, Arabic

Read English, Spanish, Arabic

Write English, Spanish, Arabic

Donor's Mother Talents:

Voice Alto

Instrumentyrs experience None

Otheryrs experience None

Donor's Mother Physical Information

Body

Age 46

Height 5'5"

Weight 130 lbs.

Hands Ambidextrous

Facial Features

Eyes:

Eye Color Brown

Eye shade Dark

Vision Normal

Glasses None

Astigmatism No

Age started wearing glasses/contactsyrs

0

Hair:

Original hair color Black

If gray, age turned grayyrs N/A

Type Wavy

Skin:

Skin Tone Med

Skin Condition Oily

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 SIBLINGS

Donor's Sibling(s) (1‐4)

Donor's Sibling #1

Full/Half sibling Full

Body

Sex Male

Age 19

Height 5'9"

Weight 160 lbs.

Hands Left‐Handed

Sibling #1 Personal Information

Occupation Certified Nursing Assistant

Education:

Level Some college

Degree Pursuing

Subject Computer Science

Religion:

Faith Christian


Languages:

Speak English

Read English

Write English

Talents:

Voice Bass

InstrumentYears of experience None

OtherYears of experience None

Sibling #1 Children:

# BoysAges: 0

# GirlsAges: 0

Eyes:

Eye color Brown

Eye shade Dark


Glasses Single

Astigmatism Yes

Age started wearing glasses/contacts 16

Hair:

Original hair color Black

If gray, age turned gray N/A

Type Straight

Skin:

Skin tone MedL

Skin condition Oily

Other:

Chin cleft Slight

Ear lobe Attached

Facial dimples None

Military

Served in military No

Branch N/A

Rank N/A

Years of service 0

Donor's Sibling #2


Sibling #2 Physical Information

Body

Sex Male

Age 13

Height 5'0"

Weight 130 lbs.

Hands AmbidextrousSibling #2 Personal Information

Occupation StudentEducation:

Level High school

Degree Pursuing

Subject General StudiesReligion:

Faith Christian

Denomination CatholicLanguages:

Speak English

Read English

Write EnglishTalents:

Voice Tenor




# BoysAges: 0

# GirlsAges: 0

Sibling #2 Facial FeaturesEyes:

Eye color Brown

Eye shade Medium


Glasses Single

Astigmatism No

Age started wearing glasses/contacts 10Hair:



Type StraightSkin:

Skin tone MedL

Skin condition DryOther:

Chin cleft None

Ear lobe Attached

Facial dimples NoneMilitary


Branch N/A

Rank N/A

Years of service 0

Donor's Sibling #3


Sibling #3 Physical Information

Body

Sex Female

Age 9

Height 4'6"

Weight 95 lbs.

Hands Right‐HandedSibling #3 Personal Information

Occupation StudentEducation:

Level Grade school

Degree Pursuing

Subject General StudiesReligion:

Faith Christian

Denomination CatholicLanguages:

Speak English

Read English

Write EnglishTalents:

Voice Soprano




# BoysAges: 0

# GirlsAges: 0

Sibling #3 Facial FeaturesEyes:

Eye color Brown

Eye shade Medium

Vision Normal

Glasses None

Astigmatism No

Age started wearing glasses/contacts 0Hair:



Type StraightSkin:

Skin tone MedL

Skin condition MediumOther:

Chin cleft None

Ear lobe Attached

Facial dimples NoneMilitary


Branch N/A

Rank N/A

Years of service 0

FATHER'S SIBLINGS

Father's Brothers

# of Brothers 2

Ages of Brothers: 64, 60

Education levels for each: Bachelor's, Master's

Occupations for each: Security Guard, Truck Driver

Religions for each: Christian, Christian

Father's Brothers' Total Children:

# Boys 0

# Girls 0

Father's Brother #1

Age: N/A

Education level: N/A

Occupation: N/A

Religion: N/A

Father's Brother #1 Total Children:

# Boys N/A

# Girls N/A

Father's Sisters

# of Sisters 1

Ages of Sisters: 61

Education levels for each: High school

Occupations for each: Office Worker

Religions for each: Christian

Father's Sisters' Total Children:

# Boys 0

# Girls 0

MOTHER'S SIBLINGS

Mother's Brothers

# Brothers 3

Ages of Brothers: 38 (deceased), 55, 44

Education levels for each: All have high school

Occupations for each: Construction, Construction, Salesman

Religions for each: All are Catholic

Mother's Brothers' Total Children:

# Boys 4

# Girls 3

Mother's Brother #1

Age N/A

Education Level N/A

Occupation N/A

Religion N/A

Mother's Brother #1 Total Children

#Boys N/A

#Girls N/A

Mother's Brother #2

Age N/A

Education Level N/A

Occupation N/A

Religion N/A

Mother's Brother #2 Total Children

#Boys N/A

#Girls N/A

Mother's Sisters

# Sisters 3

Ages of Sisters: 52, 49, 29 (deceased)

Education levels for each: High school, High school, Some college

Occupations for each: All are Homemakers

Religions for each: All are Catholic

Mother's Sisters' Total Children:

# Boys 2

# Girls 1

Mother's Sister #1

Age N/A

Education Level N/A

Occupation N/A

Religion N/A

Mother's Sister #1 Total Children

#Boys N/A

#Girls N/A

Mother's Sister #2

Age N/A

Education Level N/A

Occupation N/A

Religion N/A

Mother's Sister #2 Total Children

#Boys N/A

#Girls N/A

FATHER'S PARENTS

Father's Father

Education

Level High school

Degree Diploma


Occupation: Coal Miner


Siblings:

# Brothers 2

# Sisters 1

Other:

Languages English

Religion Christian

Military

Branch N/A

Rank N/A

Service Yrs 0

Father's Mother

Education

Level High school

Degree Diploma


Occupation: Factory Worker


Religion Christian

Siblings:

# Brothers 1

# Sisters 1

Other:

Languages English

Religion Christian

Military

Branch N/A

Rank N/A

Service Yrs 0

MOTHER'S PARENTS

Mother's Father

Education

Level High school

Degree Diploma


Occupation: Restaurateur

Primary ethnic origins: Palestinian

Siblings:

# Brothers 3

# Sisters 1

Other:

Languages Spanish, Arabic

Religion Islam

Military

Branch N/A

Rank N/A

Service Yrs 0

Mother's Mother

Education

QUESTION RESPONSE

QUESTION RESPONSE

Level High school

Degree Diploma


Occupation: Homemaker

Primary ethnic origins: Panamanian (Chiriquí)

Siblings:

QUESTION RESPONSE

QUESTION RESPONSEQUESTION RESPONSE

# Brothers 2

# Sisters 1

Other:

QUESTION RESPONSE

QUESTION RESPONSE

Languages Spanish

Religion Catholic

Military

QUESTION RESPONSE

QUESTION RESPONSE

Branch N/A

Rank N/A

Service Yrs 0

personal profile - fairfax cryobank · reading, guitar, exercising, cooking, video games, traveling...

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