Fertility Alternatives, Inc.
Preliminary Egg Donor Online Application
This is a preliminary application.
A full application will be faxed, mailed, or emailed to qualifying applicants. Please note that you
must agree to be available, in the event Fertility Alternatives, Inc. locates a match for you.
Preliminary applications who have not returned the Full Application within 30 days, will be
removed from our files.
Fertility Alternatives, Inc. is a premier Egg Donation agency.
Serious applicants only, please.

We accept Donors from all over the United States ONLY.
Gestational Surrogates must live in California to apply with this program.

If you are interested in becoming a Gestational Surrogate, Do not fill out this preliminary application. Instead please call
Fertility Alternatives, Inc. directly @ 951-696-7466 to get updated information on the application process and
requirements.
Do not fill out this form until you have viewed the information and requirements of our programs at
the website.
Information for Egg Donors
or
Information for Surrogates
Please answer ALL questions honestly and completely.
Please apply only if you will be available when a match is made.
Although we do not ask that you exclusively work with us, we do kindly request that you
give us the standard minimum of 6 months before you apply with other agencies or donor
programs. You will be seen on our list.
We have a waiting list of recipients waiting for the right donor.
We would like the opportunity to match you and provide you with the service you deserve.

Please do not apply if you are over the age of 31, a smoker, use illegal drugs, or live
outside of the U.S,
Full Address:
Please include any apartment
numbers, or other important
info needed to get the full
application mailed to you.
Do you have any genetic diseases or
illnesses that run in your family?
(i.e. Cancers, Juvenile Diabetes,  color
blindness, Fragile X syndrome, etc)

Are you taking any medications other
than Birth control pills?

Do you have any fertility problems to
include PCOS?

If you answered yes to any of the
questions above. Please explain the
the box.
Do you or any biological family
members have any psychological
disorders?
(i.e., hyperactivity, bi-polar disorder,
schizophrenia, clinical depression, etc.)
If yes, please explain:
Are you or have you attended a college or University?
If yes, the name of the University, your GPA, and
course of study.

If you have already graduated, please state when
and where, G.P.A., and what degree earned.
Are you able to obtain proof of your scores or college transcripts?
Documentation is required if you would like to be considered for
"Exceptional" status.
If you have high SAT  or ACT scores, or attending a University, please see the bottom of this page for
information about "Exceptional Donor" status.
What type of Intended Parents are
you open to working with?
If you are a prospective Egg Donor, are you willing to travel?
Note: Long distance travel is defined as approximately 7-9 days for the egg
retrieval procedure.
Travel may be required for the screening process as well and is usually no more
than 1-2 days.
Monitoring is done in your own home town.
PLEASE NOTE: Travel is not required, but extremely helpful when trying to
match you.
Why would you like to become a surrogate or egg
donor?
How does your partner and/or family feel about your interest in surrogacy or egg donation?
Do you expect your husband/partner to be supportive?
If so, please explain when and the clinic name,
and what you know specifically about the
results. As well please let us know how many
additional times you intend to donate.
(You are limited to a total of 6 cycles)
What is amount of negotiable compensation you expect for your time and
efforts as an egg donor?
Please see
http://www.fertilityalternatives.com for a reasonable guideline.

Please be advised that if your fee is unreasonably high, or you are asking
for a fee as an "Exceptional donor", and you do not qualify for Exceptional
Donor Status, that it will be very difficult to match you.

We ask that you allow us to help you determine the best fee for your
individual situation based on our experiences.
Exceptional Egg Donors are defined as attractive women who are
ages 30 and under, with SAT scores of 1250 or higher (ACT score: 30
or higher), and/or a college GPA of 3.0 or higher.
(Documentation is required.)
"Exceptional" donors are willing to take an I.Q. test. They are
height/weight proportionate, and have graduated from, or currently
attending a University (Ivy league preferred, but not necessary).
These donors can receive a much higher compensation rate from
Intended Parents with these special requests.
Please note: First time "Exceptional Donors" are asked to start at $7000-$8000.
F.A., Inc will determine actual  donor fee upon review of your application.

Experienced Donors can request a compensation rate exceeding $5000. This is because Intended
parents are willing to pay a higher compensation to donors who have been responsible enough
to complete the entire process successfully.
Fertility Alternatives, Inc. will provide you with a higher compensation rate for each additional
donation you do.
If you believe qualify for "Exceptional Donor" status
based on the requirements above, please check here.
How did you hear about Fertility Alternatives, Inc?
Please be specific.
Please note: Egg Donors must have a copy of a full, detailed application AND photos on file with Fertility
Alternatives, Inc. in order to be added to the online database and/or matched, so please return the
applications ASAP.
Applications will be mailed to potential
egg donors in a plain, handwritten envelope for privacy purposes.
* Please return actual profiles/applications by mail or fax.*
* Ideal Egg donor candidates must pass a preliminary screening process to include this online application.
As well, Surrogate and Egg donor applicants will be assessed on how serious they are about becoming a
"Fertility Assistant", based on timeliness in returning the written application, and the ability to be
contacted when needed.*
Please email an attractive, close up photo of your face to Fertility Alternatives, Inc., if available.

When you receive your full application in the mail, make sure that 3-4
attractive, clear photos of your face are enclosed with your application,
when you return it. (NO laser copies, please)
They will be scanned and returned.

You cannot be added to the database unless you mail your photos with your
full application.
Please do not send photos of your children, until we specifically ask. Thanks!
We currently have a waiting list of couples in need
of their ideal Donor.
Your help is greatly appreciated!
Full Name:
Home Phone:
Fax:
Work phone:
Age:
Email:
Natural hair
color:
Height:
Normal pre-pregnancy Weight:
Blood type:
Rh Factor:
Hair:
Eye color:
Current weight:
Ethnicity:
Race:
Religious background:
How many children do you
have?
Marital Status:
Do you smoke?
What were your SAT or ACT scores?
International Couples
Bi-racial couples
Same sex couples
Single woman
Single man
Have you ever been a donor before?
See info below before you submit your
preliminary application.
Please press "Submit" only once.