Age: 19

Location: Missoula, MT

Ethnicity: White

Compensation: $8,000.00

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)?
Religion: N/A
Are you practicing? No
Height: 5'6
Weight: 120
Eye Color: Blue
Hair Color: Red
Skin tone: Fair
Blood type if known: O+
Left or Right handed: Right Handed
Distinguishing features (Dimples, Cleft chin etc...): Two dimples on my right side and lots of freckles
Number of Siblings: Two
Sisters: None
Brothers: Two
Are you adopted? No

Family Member	Age	Height	Weight	Hair Color	Eye Color
Biological Mother	36	5'2"	160	Black	Brown
Biological Father	38	6'2"	190	Brown	Blue
Sibling/Male	15	5'9"	140	Black	Green
Sibling/Male	4	3'4"	45	Red	Brown
Sibling
Sibling
Grandmother (mother's side)
Grandfather (mother's side)
Grandmother (father's side)
Grandfather (father's side)

College/University/Vocational School:
Major:
GPA:
Did you take the SAT or ACT? No
If yes, score-
SAT:
ACT:
Favorite subjects in school: English/Writing, Anatomy & Physiology
Current Occupation & summary of job duties: Merry Maids: Cleaning Houses, To clean each of them as though it was my own and make sure each customer is happy with the results.
Any exposure to chemicals? No
If yes, what chemicals:
What are your future career plans & goals? I would like to own and run my own cosmetics business.
What are your educational goals? I would like to put myself through cosmetology and esthetician courses so that I can start my own business.

Level of Education	Name of School	Date Completed (MM/YYYY)
GED
High School	Wasilla High School	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: Never had one done
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? No
Do you use recreational drugs? No
Are you currently taking any medications? No
Please describe any medical problems you have had: N/A
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? No
Arrhythmia? No
High cholesterol? No
Atherosclerosis? No
Diabetes? No
Thyroid problems? Yes, Dads side of the family
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'm a fun loving, sometime shy, individual, who enjoys adventures an trying new things.
What are your hobbies, interests and talents? I enjoy crocheting and knitting, swimming and paddle boarding. I play several instruments and I enjoy reading as well.
Do you play a musical instrument? Yes , Flute, piccolo, percussion, and saxophone.
Do you have any particular athletic abilities? No
Do you have any artistic talents? Yes, I enjoy Painting as well as drawing
What do you like to do in your spare time? I enjoy crocheting and painting, but i'm more of a go with the flow type of person.
Why do you want to be an Egg Donor? I want to be an egg donor to help put myself through school, but I also want to help people make their picture perfect happy household :)
What are your favorite books? Currently I'm enjoying the Splintered Series.
What are your academic strengths? I'm very good at reading and writing
What accomplishments are you particularly proud of? I am proud of pushing myself to graduate High School with my best efforts. I'm also proud of being on my own at 18, being that most stay with their parents for years after becoming adults.
If you could pass on a message to the recipient(s) of your egg donation, what would that message be? I would say to make the decision that's best for you. I understand that there's a lot of pressure for you to decide on a donor, but it all takes time and that's okay. Remember that it's okay to be nervous or unsure but in the end I hope you end up with a beautiful happy family!!
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? N/A
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?
Yes , Open (Intended Parents meet you and know you. Exchange email address and/or phone number).