Fertility Alternatives, Inc.
Preliminary Egg Donor Application
This is a preliminary application.
A full application will be faxed, mailed, or emailed to qualifying
applicants. Please note: You must agree to be available within a
reasonable time frame in the event Fertility Alternatives, Inc. locates
a match for you.

Please review the following information prior to filling out this
preliminary application.
Preliminary applications who have not returned the Full Application
within 30 days, will be removed from our files.

Please apply only if you will be available when a match is made.

As a premier egg donor program, you will be seen on our donor list!
I have a waiting list of recipients looking for the right donor.

Please do not apply if you are over the age of 30, a smoker, use
illegal drugs, or live outside of the U.S.

Do not fill out this form until you have read and clearly understand
the information provided on the
EGG DONOR INFORMATION PAGE.
Serious applicants only, please.
Please answer ALL questions honestly and
completely.
AGE
RACE
Have you even been
pregnant?
ETHNICITY
Religious Background
Marital Status
If you are married or have a
partner, please be sure you will
have his/her support before
you apply with this program.
Do you have any genetic disease or
illness that runs in the family?
(i.e. cancers, Diabetes, color blindness,
Fragile X syndrome, Cystic Fibrosis, or
other genetically carried disorder)
If yes, please explain
Have you been diagnosed with
PCOS or other fertility problem?
If yes, Please explain
Are you using any form of hormonal
birth control?
(i.e. pill, patch, injection, nuvaring, etc.)
If so, what?
Are you taking any medications
other than birth control pills? If yes,
what are you taking and its
purpose?
Have you or any of your family
members been diagnosed with any
psychological disorders that may be
genetic?
(i.e. hyperactivity, Bi-polar disorder,
schizophrenia, clinical depression, etc.)
If yes, Please explain.
Have you or are you attending a
college or University?
If so, please indicate the name of the
university, course of study, and your
GPA.
If you have already graduated please
state when and where you
graduated, your GPA and the degree
earned.
Are you able to provide proof of
your college transcripts and/or your
SAT/ACT scores?
You will be required to provide some
documentation proving your educational
status if you are applying for  
"Exceptional Donor" status.
If needed, are you available for a cycle
that requires travel?
Most travelling cycles, require 1-2 days for
screening, and 7-10 days for the egg retrieval
procedure. Monitoring will be done in your local
area.
Travel is not a requirement but will get you
matched significantly sooner and more often
than if you were only available for local matches.
Why would you like to be an egg donor?
and
What is the negotiable amount of
compensation you would like to request?
Please see Fertility Alternatives, Inc. Egg Donor
Information Page for reasonable guideline.*
Please note: The average first time Exceptional Egg Donor is asked to start at a compensation of $8000.
Exceptional Donors are defined as women under the age of 30, with old SAT scores of 1280+
and new SAT scores of 1800+ (ACT score 30+) and/or college GPA of 3.0 or higher.
(Documentation Required)
Exceptional Donors are reasonably attractive, height/weight proportionate, have graduated
from or currently attending a major university. (Ivy League preferred but not necessary.)
If you believe you qualify for Exceptional Donor Status, please check here.
How did you hear about Fertility Alternatives, Inc?
(Be specific.)
Are you willing to accept exclusive representation
by Fertility Alternatives, Inc.?
This is a requirement of the program like any talent or modeling agency
and allows me to match you sooner with the best compensation
available given the current market.
NOTE: Egg Donor applicants must have photos on file in order to be accepted into the program and
to be added to the egg donor database.
Please be sure you include them with your full application if you receive one.
Full applications will be emailed or may be mailed in a plain handwritten envelope for privacy
purposes.

Ideal egg donor candidates must pass a preliminary screening process to include this online
preliminary application. Egg Donor applicants will be assessed on how serious they are about the
process, based on a timely return of the full application and the ability to be contacted when needed.
Feel free to email a photo of yourself to Dawn @Fertility Alternatives, Inc.
We currently have a waiting list of couples in need of their ideal Donor.
Your help is greatly appreciated!