Sperm Donor Application - New Dawn Surrogacy

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Sperm Donor Application

Home
Intended Parents
Surrogates
Blog
Referral Program
Sperm Donor Application

Become a Donor

Help Others Build Their Family

First Name *

Last Name *

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City *

State/Province

ZIP / Postal Code

Country *

How do you prefer to be contacted? *

What is your relationship status? *

What is your preferred pronoun? *

Please enter your preferred pronoun.

What is your height?

Feet *

Inches *

What is your weight? *Please enter in pounds.

What is your race?If applicable, include multiple races.

What is your sexual orientation? *

What is your ethnicity?

From your mother's side? *

From your father's side? *

Are you religious? If so, which religion(s)?

What is your highest level of completed education? *

What college did you attend?

What is/was your field of study?

Any achievements or honors in school or work?

How often do you use marijuana or hemp? *Recreationally, medically, or otherwise.NeverOnce or twice everOnce or twice a yearSix or more times a yearMonthlyWeeklyDaily

How often do you smoke or vape? *Tobacco, nicotine, marijuana, or otherwise.NeverOnce or twice everOnce or twice a yearSix or more times a yearMonthlyWeeklyDaily

How often do you drink? *NeverOnce or twice everOnce or twice a yearSix or more times a yearMonthlyWeeklyDaily

What is your blood type? *

Have you undergone testosterone therapy? *

Do you currently suffer from any health concerns? If so, explain. *

Have suffered from any health concerns in the past? If so, explain. *

Please list any and all medications you have taken within the past year, including supplements? *Whether it be for physical health or mental health, prescription or OTC, please include it all!

Does your family have a history of serious illness? If so, explain. *

Does your family have a history of cancer? If so, explain. *

Does your family have a mental illness? If so, explain. *

Have you ever tested positive for any STDs or STIs? *

Which STDs/STIs, and how long ago?

Are you currently sexually active? *

Your sexual partners are primarily? *

How many sexual partners have you had in the past 6 months?

Why are you looking to become a sperm donor? *

What type of parents are you willing to donate to? *Check all that apply.LGBTQ+ CouplesHeterosexual CouplesSinglesAnyone

What is your desired compensation rate?Amounts should be in USD.

USD

Do you have any social media accounts you're willing to share? If so, please list your username(s).

Please upload 3-5 photos of yourself! *

Drag and Drop (or) Choose Files