Jennifer Lucero Earle
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Your Contact Information
Date of birth
This information is required for Primordial Sound Meditation training. For this section we'd like to know the month, day, and year you were born.
This information is required for Primordial Sound Meditation training. For location, we'd like to know city/town, state, and country.
Time of birth
This information is required for Primordial Sound Meditation training. For this section we'd like to know the hour and minute you were born. Be sure to include whether it was and AM or PM birth. If you do not know the exact time of your birth, please write "I'm timeless!"
Emergency Contact Information
We need a few bits of demographic information.
Body identity (Gender)
Sexual identity (Orientation)
I usually like men.
I usually like women.
I usually like men and women.
I usually like people who like me.
I usually don't like anybody.
I'm too damn old to think about this.
I'm really not sure about this yet.
Years of Seasoning (Age)
41 - 45
Abundance perception (Income)
More than enough
More money that I can spend
Not even close to enough
Enough if it weren't for my kids/family/ex
Enough if it weren't for my student loans/credit debt
Enough if it weren't for my shoe/purse/fantasy football/bacon addiction
Personal bliss/Partnership status (Marital status)
Surprised to be single
Single and hoping to keep it that way
Single and sick of it
Single and deeply satisfied
Married for the kids/money/security
Married to my best friend
Divorced and consider it better for all
Divorced and didn't want it
Divorced and damn happy about it
Widowed very recently
Widowed and relieved
Widowed from the love of my life
Committed relationship and shacking/living together
Committed relationship and we do better in separate spaces/homes/states
Committed relationship with married person
Committed relationship that needs to wrap up
Daily Bliss (Employment)
Part-time (less than 20 hours per week)
Full-time (30+ hours per week)
Self-employed - Artist/Activists
Self-employed - Small business (less than $250,000)
Small business owner (less than $250,000)
Small business owner ($250K - $1M)
Small business owner ($1M - $3M)
Business owner ($3M+ and growing)
Not employed - by choice
Not employed - by chance
Retired and resting
Retired and working to keep busy
Full time volunteer
Part time volunteer
Full time caregiver for kids/elders/beloveds
Part time caregiver for kids/elders/beloveds
Some High School
Completed High School
Certifications (Reiki, Nia, Yoga, etc.)
Ancestral & Cultural Identity (Ethnicity) - How do you see/identify yourself based on your ancestry and cultures?
So, this is really up to you. We trust you more than anyone to tell us who you are and how you see yourself. While we will eventually, we'll add the list of 150+ ethnicities and 350 federally recognized tribes, we think it's most important for you to name yourself in this moment. So, have at it.
Are you currently or have you ever been a parent?
I'm a survivor.
I've got serious street smarts.
I can fix just about anything.
I can read people.
I drink and I know things.
I can talk my way out of or into anything.
I know who I am.
I seen some things and am not easily surprised.
Ancestral & Cultural Identity (Ethnicity) - How do others within your ancestral and cultural groups tend to identify you?
Within most cultural groups, their are important clarifications related to identity. This is an opportunity to add that information if it feels relevant.
Ancestral & Cultural Identity (Ethnicity) - How do others outside of your ancestral and cultural groups tend to identify you?
We want to know what the world outside of you and your community assumes about your ancestral and cultural identities. This helps us to learn a bit more about how the world engages with you.
Tell us more about your relationship with parenting.
Now for the good stuff. Tell us more about you.
Do you currently have a regular meditation and/or prayer practice?
Do you currently have a regular movement or exercise practice?
Tell us more about your relationship with meditation and/or prayer.
Tell us more about your relationship with movement and/or exercise.
What was the last thing that made you laugh?
What was the last thing that made you cry?
What are you feeling nervous about?
What has you feeling optimistic?
What parts of life/love/leadership feel unstable?
What is something you really want?
What parts of life/love/leadership feel steady?
What is something you really, really want?
What do you hope to experience during the workshop/retreat?
What else do you want us to know about you? How do you want to be seen?
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Jennifer Lucero Earle