Age: 20

Location: Midvale, UT

Ethnicity: White

Compensation: $8000.00

Available: Yes

Previous: No

Proven: No

Age (at time of application): 20
Ethnicity: White
Mother's Ethnicity: White
Father's Ethnicity: White
Do you speak any language(s) other than English? No
Religion: Christian
Are you practicing? Yes
Height: 5’3
Weight: 112lbs
Eye Color: Brown
Hair Color: Brown
Skin tone: Fair
Blood type if known: B+
Left or Right handed: Right handed
Distinguishing features (Dimples, Cleft chin etc...): Beauty mark on my upper left lip.
Number of Siblings: 5
Sisters: 4
Brothers: 1
Are you adopted? No

Family Member	Age	Height	Weight	Hair Color	Eye Color
Biological Mother	38	5'2	175lbs	Brown	Brown
Biological Father	40	6'3	210lbs	Red	Blue
Sibling	4	3'4	40lbs	Brown	Brown
Sibling	18	4'11	125lbs	Red	Hazel
Sibling	10	4'6	60lbs	Red	Blue
Sibling
Grandmother (mother's side)	60	5'3		Brown	Brown
Grandfather (mother's side)	58	5'4		Brown	Hazel
Grandmother (father's side)	62	5'6		Brown	Blue
Grandfather (father's side)

College/University/Vocational School: N/A
Major: N/A
GPA: N/A
Did you take the SAT or ACT? Yes
If yes, score-
SAT: N/A
ACT: 27
Favorite subjects in school: Band and Science
Current Occupation & summary of job duties: Veterinary Technician Assistant. I assist the technicians with restraining the animals. I am also responsible for helping to keep the clinic clean (i.e cleaning kennels)and filling meds, administration of meds and overnight patient care.
Any exposure to chemicals? Yes
If yes, what chemicals: Cleaning chemicals.
What are your future career plans & goals? I want to become a veterinary technician.
What are your educational goals? I aim to go back to school to get my certification for Veterinary Technician.

Level of Education	Name of School	Date Completed (MM/YYYY)
GED
High School	South Sevier High School	05/26/2022
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
Do you have a regular monthly menstrual cycle (every 21-35 days)? Yes
Do you smoke? No
Do you drink alcoholic beverages? Yes
If yes, how often? 2-3 times a month
Do you use recreational drugs? No
Are you currently taking any medications? No
Please describe any medical problems you have had: I have asthma from having RSV as an infant. I also had a heart arrhythmia that was fixed with a non invasive surgery.
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? No
Asthma? Yes - I have it from having RSV as a child.
Heart disease? No
Heart attack? No
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? Yes - Grandparents from old age.
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? Yes - Mother
Schizophrenia? No
Suicide attempt? No
Other mental illnesses? No
Please describe your personality and character: I am typically an easy going person. I am an empath and love to be able to help others. I am stubborn though and do not like asking for help and if I have my eyes set on something I don't quit until I get what I want
What are your hobbies, interests and talents? I love to read, fish, do puzzles, and bake.
Do you play a musical instrument? Yes - Clarinet
Do you have any particular athletic abilities? No
Do you have any artistic talents? No
What do you like to do in your spare time? I like to read, bake, clean, hike, fish, spend time outside.
Why do you want to be an Egg Donor? I want to be able to help families either expand or begin.
What are your favorite books? Fantasy
What are your academic strengths? I’m great at science.
What accomplishments are you particularly proud of? Being the first in my family to graduate from high school and moving out of my hometown.
If you could pass on a message to the recipient(s) of your egg donation, what would that message be? I am so grateful you have chosen me to help you grow your family. This means the world to me and I have always wanted to be able to help families in this way. So thank you again from the bottom of my heart.
Have you ever been an egg donor? No
Have you ever been pregnant? No
How many children do you have? No
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).