Donate My Sperm

Estimated completion time: 3 – 5 minutes

Thank you for your interest in becoming a sperm donor!

Please complete this short prescreening questionnaire. Our team will review, and if you qualify, we will send you a longer followup questionnaire.

Give the gift of life and earn $500 – $1,000 for your time!

Tell us about yourself.

Donate My Sperm

What is your first name?

What is your last name?

In which country were you born?

Are you a US citizen or permanent resident?

Yes

No

Are you eligible to work in the United States?

Yes

No

What is your email address?

What is your cell phone number?

What is your height?

What is your weight (in pounds)?

What is your date of birth?

Are you adopted?

No

Yes, and I know my biological mother

Yes, and I do not know my biological mother

With which ethnicity do you identify?

Non-Hispanic Black or African American

East African Black or African American

Central African Black or African American

West African Black or African American

Hispanic Black

Hispanic or Latino

Native American or Alaska Native

East Asian (Chinese, Japanese, Korean, Taiwanese, Mongolian)

Southeast Asian (Filipino, Vietnamese, Thai, Malaysian, Indonesian, Khmer, Laotian, Burmese, Singaporean)

Central Asian (Kazakh, Uzbek, Turkmen, Kyrgyz, Tajik)

South Asian (Indian, Pakistani, Bangladeshi, Sri Lankan, Nepali, Bhutanese, Maldivian)

Native Hawaiian or Pacific Islander

Ashkenazi Jew

Sephardi Jew

Mizrahi Jew

French Canadian White

Cajun White

Western European White

Eastern European White

Middle Eastern/Arabic

Mixed Ancestry

Other

Do you have a drivers license or a state issued ID?

Yes

No

What is your current occupation?

What is your highest level of education?

Completed high school

Currently enrolled in college

Some college

Technical school degree

Completed college two-year degree

Completed college four-year degree

Currently pursuing an advanced degree

Completed advanced degree

Did not complete high school

Received GED

Degree or major

Do you have both testes?

Yes

No

Are you currently on testosterone replacement?

Yes

No

Are you currently taking any steroids?

Yes

No

Have you had a baby in the last six months?

Yes

No

Have you applied or been screened to be a sperm donor before?

Yes

No

How many times have you donated?

0

1

2

3

4

5

6+

Do you smoke cigarettes or vape nicotine?

Yes

No

Have you ever used recreational or illicit drugs (cocaine, LSD, heroin, barbiturates, narcotics, opiates, amphetamines, hallucinogens, tranquilizers, PCP, steroids) for non-medical reasons?

Yes

No

Have you traveled outside of the continental US in the last six months?

Yes

No

Have you spent five or more years cumulative in Europe?

Yes

No

Have you been vaccinated for COVID-19?

Yes

No

If you were vaccinated, which vaccine did you receive? And, what were the date(s) of your vaccination? If you are not vaccinated, would you consider getting vaccinated?

How did you hear about us?

Billboard

Craigslist

Employee

Event Booth

Facebook

Flyer/Brochure

Google

Instagram

Newspaper/Magazine

On Campus

Orlando Weekly

Pandora

Pride Festival

Radio

Snapchat

Spotify

Donor Referral

Friend Referral

Doctor Referral

Other