Age: 18

Location: Dyer, IN

Ethnicity: Hispanic or Latino

Compensation: $8000.00

Available: Yes

Previous: No

Proven: No

Age (at time of application):
Ethnicity:
Mother's Ethnicity:
Father's Ethnicity:
Do you speak any language(s) other than English?
If yes, what language(s)?
Religion:
Are you practicing?
Height:
Weight:
Eye Color:
Hair Color:
Skin tone:
Blood type if known:
Left or Right handed:
Distinguishing features (Dimples, Cleft chin etc...):
Number of Siblings:
Sisters:
Brothers:
Are you adopted?

Family Member	Age	Height	Weight	Hair Color	Eye Color
Biological Mother	50	5'0	155lbs	Brown	Brown
Biological Father	55	5'11	220lbs	Brown	Brown
Sibling	18	5'9	160lbs	Brown	Brown
Sibling
Sibling
Sibling
Grandmother (mother's side)	75	4'10	140lbs	Brown	Brown
Grandfather (mother's side)
Grandmother (father's side)	85	4'11	125lbs	Brown	Brown
Grandfather (father's side)	81	5'9	140lbs	Brown	Brown

College/University/Vocational School: N/A
Major: N/A
GPA: N/A
Did you take the SAT or ACT? No
If yes, score- N/A
SAT: N/A
ACT: N/A
Favorite subjects in school: History
Current Occupation & summary of job duties: I work at a clothing store named Hollister and am currently enrolled in EMT school.
Any exposure to chemicals? No
If yes, what chemicals: N/A
What are your future career plans & goals? I plan on going to paramedic school. My goal is to become a paramedic captain and or lieutenant.
What are your educational goals? To go to paramedic school!

Level of Education	Name of School	Date Completed (MM/YYYY)
GED
High School	Marian Catholic High School	05/2024
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? I have not received one yet.
Are you currently using birth control? Yes
If yes, which type & for how long? I’ve had an arm implant for 2 years.
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: I have hip dysplasia, but it was due to an injury.
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? No
Heart disease? No
Heart attack? No
Coronary artery disease? No
High blood pressure? Yes - My father, my uncle( mothers side), more than 5 but less than10 of my cousins
Arrhythmia? No
High cholesterol? No
Atherosclerosis? No
Diabetes? Yes - only on my mothers side. My uncle, and his two children.
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 care deeply about others, whether I have been close to them for years or I have just met them. I hear my friends say that I am the mother of the group. Besides that I do see myself as a very outspoken person. I will always say what’s on my mind, but I do it as respectful as possible. I do tend to get annoyed easily, but when I get annoyed, I tend to do something that I enjoy in order to feel calm again.
What are your hobbies, interests and talents? My interests include animals, criminology, healthcare, sports, and dinosaurs. I love reptiles and exotic pets. I currently have a bearded dragon, and I love them as I would love a child. I am interested in healthcare and that’s why I want to become a paramedic. I have a obsession with criminology. When it comes to criminology, I read books, and I watch documentaries about serial killers, and about missing cases. I am also interested in paleontology. I think that they’re just amazing creatures.
Do you play a musical instrument? Yes
If yes, what? I played the flute for 3 years
Do you have any particular athletic abilities? No
Do you have any artistic talents? Yes
Please explain: I love the do pottery.
What do you like to do in your spare time? I like spending time with my friends and my lizard. Staying home is nice but I’d rather go out and explore. When I’m home I enjoy reading and watching crime documentaries. Recently I’ve started enjoying taking care of plants.
Why do you want to be an Egg Donor? I think becoming an egg donor, would give me a sense of happiness. I would be helping men and women achieve their goals on having a child.
What are your favorite books? I have multiple favorite books. Number one would be Jurassic park by Michael Crichton. My second one would be the Stranger Beside Me by Ann Rule. And the third book would be The Lost World by Michael Crichton. Some honorable mentions: Scarlet Letter, and Lord of the Flies.
What are your academic strengths? I enjoy school, I noticed that I like to do my work right away. The day my teacher assigns a project, I am usually done the next day. I like doing all the work by myself, I like doing things my way.I do not like to wait, I like to get things done right away. Which is why I do all my homework at school, so I have no homework at home.
What accomplishments are you particularly proud of? Trigger warning. When I was a child, I was sexually assaulted by my cousin from first grade to fifth grade. I had gotten the courage to speak up when I was a sophomore. I am glad that I became the bigger person and I didn’t let that terrible person get the best to me.
If you could pass on a message to the recipient(s) of your egg donation, what would that message be? Just don’t be too hard on yourself. It’s your first time living on this earth. You’re going to make mistakes, but you’re also gonna make amazing memories.
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? If so what? No
What type of egg donation arrangement do you wish to have with the Intended Parents?
Open (Intended Parents meet you and know you. Exchange email address and/or phone number).