PHYSICAL CHARACTERISTICS
 

Height: 6' 1"	Weight: 170	Hair Color: Blond
Eye Color: Blue	Hair Type: Thick, Curly	Complexion: Fair, Tans fairly easily
Race: Caucasian	Mother's Ethnic Background: German, Dutch  Father's Ethnic Background: German, English, Irish
Blood Type: A +

FAMILY AND MEDICAL HISTORY
For each item below, if there is a history of the condition, the condition poses a risk of one percent or less to offspring.
The family relationship is indicated.

Alcoholism:	Edema:	Mental disorders:
Allergy:	Emphysema:	Mental retardation:
Anemia:	Epilepsy:	Miscarriages:
Asthma:	Glaucoma:	Stillbirths:
Blindness:	Goiter:	Migraine:
Cancer: PGF, MGM (breast)	Gout:	Muscular dystrophy:
Cataracts:	Heart attack:	Myasthenia gravis:
Cirrhosis:	Heart disease:	Paraplegia:
Cleft palate or lip:	Hemophilia:	Parkinson's:
Club foot:	Hermaphroditism:	Psoriasis:
Color blindness: Brothers	Hernia, inguinal: Self	Sickle cell anemia:
Cystic fibrosis:	Huntington's chorea:	Tay Sachs disease:
Deafness:	Hypertension:	Thalassemia:
Diabetes:	Jaundice:	Undescended testicles:
Dislocated hip:	Juvenile arthritis:
Eczema:	Lymphedema:

ABBREVIATIONS: M=Mother, or Maternal S=Sibling F,P=Father, or Paternal
N=Nephew or Niece GF, GM=Grandfather, Grandmother
A=Aunt U=Uncle C=Cousin

MEDICAL HISTORY COMMENTS: The donor's parents, siblings, aunts, uncles, and MGF are living and in good health. The MGM died at 59 of breast cancer, the PGF at 55 of cancer, the PGM at 73 of an accident. The donor is a fraternal twin.

Donor's vision: nearsighted.

Donor's dental history: a few cavities; three wisdom teeth have been pulled.
 

EDUCATION:	Subject of study	Location of University	Type of University
> 1 year college
Baccalaureate Degree	B.A. (International Relations and Economics)	Oregon	small, private liberal arts college
Master's Degree	M.A. (Teaching [emphasis: high school social studies])	Oregon	small, private liberal arts college
Professional Degree

OCCUPATION: Currently division director for a manufacturer of athletic goods; previously taught English in Korea.

STATE OF BIRTH: Oregon     YEAR OF BIRTH: 1968     RELIGION: (left blank by donor)

Social History:

1. Do you have any special talents?
I've always been quite good at mathematics; however, my interests and talents are spread into many different areas, so I've never specialized.

2. Are there any special talents that seem to run in your family? (athletics, music, artistic, etc.)
High I.Q.'s: two aunts, an uncle and cousins involved in MENSA.

Dry, witty sense of humor.

3. What are your interests and hobbies?
Reading: I've always loved reading including books from the classics to contemporary to philosophy.

Sports: My central passion has been soccer, but I love golf, running, tennis, skiing, volleyball, and working out. I also enjoy softball, racquetball, basketball, swimming and gymnastics, but I don't play them as often. If hiking and camping were considered a sport, I would throw them into the list. I suppose with all the exercise involved in backpacking around the world, I could at it to the list.

Traveling: I have traveled extensively around the world (Europe, Asia) and have lived abroad for over two years of my life.

I enjoy being with friends, watching movies, playing in the sun and most recently learning about wine.

4. What did you enjoy studying in high school and college?
I enjoyed math, science, and social studies in high school, but after living in Germany I became interested in politics and economics then issues of equality, social justice and psychology.

5. High School GPA 3.3     College GPA 3.3     I.Q.

6. How would you describe your personality characteristics?
Sociable, outgoing, funny, witty, assertive, caring, giving, intelligent, leader, thoughtful, curious, compassionate, empathetic (in no particular order).

7. Undergraduate major:     International Affairs

Graduate major:     Teaching high school social studies

8. Why do you want to be a sperm donor?
I chose to be a donor for a number of reasons. I initially got inspired by hearing stories about people (friends) struggling to have children. I thought many deserved to have children, as I hope to do. The decision to look into the program was made all the easier because my brother had already been a donor while going to school in D.C. These reasons combined with the pleasure of additional income made it an easy one to make.

Additional Descriptive Characteristics:

Handedness: Foot/Shoe Size:

Hairy Chest: Hairy: Beard Color: Light Brown

Any Distinguishing Features (Dimples, Cleft Chin, Roman Nose, Freckles, etc.):
Great smile.

Acne problems:
No

Reactivity/Sensitivity to sun exposure:
Tans fairly easily.

Do you smoke?
No

Family Social History:
 

	Education	Occupation	Interests
PGF	university	banker (vice president)	succeeding
PGM	university	housewife	traveling
MGF	university	insurance	golf, reading
MGM	life	housewife	gardening, raising kids
Father	university	businessman	reading, woodworking
Mother	some university	administrative assistant; housewife	gardening, shopping
Brother	some university	eclectic	fishing
Brother	university	restaurants
Sister (twin)	university	administrative assistant	health, psychology
Cousin	university	business	women
Cousin	graduate	education	reading
Aunt	graduate	education; teacher	outdoor activities
Aunt	university	librarian	outdoor sports, nature
Aunt	university	housewife	MENSA, social clubs
Uncle	university	executive; wood products	reading, traveling
Uncle	graduate university	government employee; accountant	reading, family