1. Describe the main reason we won't be romantically
linked going forward: | |
If other, please explain: | |
2. How would you describe my abilities as a love interest: | |
If other, please explain: | |
3. Does your not seeing me anymore have anything to
do with (choose one): | |
Fill in the blank for E or Other, please
explain: | |
4. What was your favorite quality of mine? | |
Did you really think I would put an 'other'
for this one? | Empty |
5.
What was one thing I need to work on? | |
If other, please explain: | |
6. Describe any extenuating circumstances that have
nothing to do with me and will make me feel better about your decision (choose all that apply): | Empty |
a) I have a boyfriend/girlfriend. | |
b) I have a husband/wife. | |
c) I have a fear of committing to anyone or anything.
Seriously, I won't even sign a contract for my cell phone service. | |
d) I'm gay and/or strait (but just realized it). | |
e) I'm moving. | |
f) Other | |
If other, please explain: | |
Additional Comments and/or Beseeching
for Reconcilement: | |
|