Age: 19

Location: Pingree, ID

Ethnicity: White

Compensation: $8000.00

Available: Yes

Previous: No

Proven: No

Age (at time of application): 19
Ethnicity: White
Mother's Ethnicity: White
Father's Ethnicity: White
Do you speak any language(s) other than English? No
If yes, what language(s)? N/A
Religion: Mormon
Are you practicing? Yes
Height: 5’5
Weight: 150lbs
Eye Color: Green
Hair Color: Blonde
Skin tone: Pink and red undertones
Blood type if known: B+
Left or Right handed: Right handed
Distinguishing features (Dimples, Cleft chin etc...): Freckles
Number of Siblings: 6
Sisters: 2
Brothers: 4
Are you adopted? No

Family Member	Age	Height	Weight	Hair Color	Eye Color
Biological Mother	61	5'9	160lbs	Blonde	Green
Biological Father	60	5'9	230lbs	Brown	Blue
Sibling	35	5'11	220lbs	Brown	Green/Hazel
Sibling	22	6'0	160lbs	Blonde	Green
Sibling	36	5'1	170lbs	Brown	Green
Sibling	25	5'3	120lbs	Blonde	Green
Grandmother (mother's side)	83	5'6	170lbs	Brown	Green
Grandfather (mother's side)		6'1		Blonde	Blue
Grandmother (father's side)	79	5'0	170lbs	Strawberry Blonde	Blue
Grandfather (father's side)	82	5'10	220lbs	Brown	Blue

College/University/Vocational School: N/A
Major: N/A
GPA: N/A
Did you take the SAT or ACT? Yes
If yes, score-
SAT: 1020
ACT: 17
Favorite subjects in school: Science and Math
Current Occupation & summary of job duties: Substitute Teacher. Watch over a class room of children. Teach new or continue teaching new topics. Maintain policy and rules.
Any exposure to chemicals? No If yes, what chemicals: N/A
What are your future career plans & goals? To become a teacher.
What are your educational goals? To finish college.

Level of Education	Name of School	Date Completed (MM/YYYY)
GED
High School	Snake River High School	May 2023
College/University
Bachelor's Degree
Associate Degree
Master's Degree
Other:

Health History:
Have you ever been pregnant? No
Do you have any children? No
Have you ever placed a child up for adoption? No
Any history of infertility in your family? No
Deliveries: N/A
#1: Date of delivery: Months trying to conceive:
Birth Weight: At how many weeks/days did you deliver? wks days
#2: Date of delivery: Months trying to conceive:
Birth Weight: At how many weeks/days did you deliver? wks days
#3: Date of delivery: Months trying to conceive:
Birth Weight: At how many weeks/days did you deliver? wks days
Date of last Pap Smear: Were the results normal? Never had one.
Are you currently using birth control? No
If yes, which type & for how long? N/A
Do you have a regular monthly menstrual cycle (every 21-35 days)? Yes
Do you smoke? No
Do you drink alcoholic beverages? No
Do you use recreational drugs? No
Are you currently taking any medications? No
Please describe any medical problems you have had: None
Have you or any of your biological relatives (including your parents, siblings, aunts, uncle, cousins and children) suffered from: (if yes, explain)
Physical birth defects? No
Down Syndrome? No
Mental Retardation? No
Ovarian Cysts? No
Uterine Fibroids? Yes - Half sister
Asthma? No
Heart disease? Yes - Grandfather and Uncle
Heart attack? Yes - Grandfather and Uncle
Coronary artery disease? No
High blood pressure? No
Arrhythmia? No
High cholesterol? No
Atherosclerosis? No
Diabetes? No
Thyroid problems? No
Blood clotting disorder? No
Anemia? No
Learning disability/ies? No
Blindness? No
Hearing loss? No
Osteoporosis? No
Dwarfism? No
Huntington’s disease? No
Chronic heartburn? No
Alzheimer’s disease? No
Parkinson’s disease? No
Cerebral Palsy? No
Muscular Dystrophy? No
Seizure Disorder/Epilepsy? No
Cystic Fibrosis? No
Kidney disease? No
Any type of cancer? No
Seriously overweight? No
Multiple birthmarks? No
Alcoholism/heavy alcohol use? No
Recreational or prescription drug abuse? No
Been treated by a psychiatrist? No
Depression? No
Schizophrenia? No
Suicide attempt? No
Other mental illnesses? No
Please describe your personality and character: I have a bubbly personality. I’ve been told that I’m very personable and can talk to anyone. My smile has been said to light up a room.
What are your hobbies, interests and talents? I enjoy being outdoors whether is being on the boat, hiking or just playing. I enjoy crocheting and watching movies. I pick up things very easily and can sing.
Do you play a musical instrument? Yes
If yes, what? Piano and viola
Do you have any particular athletic abilities? Yes
Please explain: I ran track and made it to state three years. I played volleyball in junior high.
Do you have any artistic talents? Yes
Please explain: I love to draw and have taken several art classes.
What do you like to do in your spare time? I love to spend time with the people I love. I crochet and help out anyone I can.
Why do you want to be an Egg Donor? I am wanting to help those who need assistance in having a baby.
What are your favorite books? My favorite boot is the hunger games series.
What are your academic strengths? I was a 4.0 student and graduate top of my class of 250 students.
What accomplishments are you particularly proud of? As a senior in high school I fundraised over $3,000.00 to get accessible seating in our high school auditorium. I also received over $100,000.00 in scholarships.
If you could pass on a message to the recipient(s) of your egg donation, what would that message be? I hope your ready for a sweet and caring little baby that will nap anywhere.
Have you ever been an egg donor? No
If yes, when and with what clinic/doctor: N/A
If yes, number of times you’ve donated: N/A
Have you ever been pregnant? No
How many children do you have? None
Any history of infertility in your family? No
What type of egg donation arrangement do you wish to have with the Intended Parents?
Semi-open (Intended Parents meet you, but do not have contact information).