Relationship Report Form
The purpose of this form is to collect information related to human mate preferences based upon the results of both short-term and long-term relationships. Please fill in the following form as completely as possible, using one form for each relationship you wish to report. Data collected on these forms will be used by C. Kevin Barrett in a research project focusing on human mating strategies. Information about sexual practices is not required. If you do not know the answer to a particular question please leave it blank. Depending on your answers I may have several "follow-up" questions regarding a particular relationship -- if you wish to be contacted regarding these questions, please fill in your email address at the bottom. If you wish for your answers to remain anonymous, please leave the email address blank.
NOTE: For the purposes of this research, a relationship is defined as "any association with a person that resulted in sexual intercourse, regardless of whether either person was single."
For the last three questions you are welcome to compose your answers off-line and then Cut and Paste your answer into the dialogue box.
1. Personal Information
Your Sex*
Male
Female
Their Sex*
Male
Female
Your Age (in years)*
Email Address
Last grade that you completed in School
2. Summary of Relationship
Length of the Relationship (in months). If the relationship lasted less than a month, please enter "0"*
How soon (in months) after the relationship started did you first have sex? If you slept with the person immediately, enter "0"*
Which of the following categories best describes why the relationship ended?*
What first attracted you to this person? Where and when did this occur?
Why do you think the relationship ended?
If asked, what would your ex state as the reason why the relationship ended?
Thank you for your participation. If you are satisfied with your answers, please press "Submit".