D.D.B. Breakthrough™ Coaching Application

1
Name
First Name
Last Name
2
Email
example@example.com
3
Phone Number
Please enter a valid phone number.
4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Age Range
18–24
25–34
35–44
45–54
55+
6
Occupation/Business
7
How did you hear about Shelby or the D.D.B. Framework?
8
Have you completed the “Break the Cycle Challenge” or Quiz?
YESNO
9
How would you describe the current season of your life right now?
Clarity & focus
Transition & uncertainty
Burnout or confusion
Expansion & alignment
10
What do you sense God is calling you to build, steward, or focus on in this season?
Huge
Large
Normal
Small
Ok
Ok
11
What feels unclear, confusing, or stuck for you right now?
Huge
Large
Normal
Small
Ok
Ok
12
On a scale of 1–10, how clear are you about your purpose or next assignment?
1 - Not at all clear
Somewhat Satisfied
Satisfied
10 - Crystal clear
Service Quality
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Service Quality
1 - Not at all clear
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Somewhat Satisfied
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Satisfied
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10 - Crystal clear
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What emotional or spiritual patterns do you notice repeating in your life or business?
Huge
Large
Normal
Small
Ok
Ok
14
Which of these feel most dominant right now?
Fear or procrastination
Perfectionism
Shame or guilt
Control or self-reliance
Over giving or burnout
15
What old mindsets or lies are you ready to let go of?
Huge
Large
Normal
Small
Ok
Ok
16
On a scale of 1–10, how willing are you to confront what’s not working?
1 = Resistance
Somewhat Satisfied
Satisfied
10 - Fully Willing
Service Quality
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Service Quality
1 = Resistance
Row 0, Column 0
Somewhat Satisfied
Row 0, Column 1
Satisfied
Row 0, Column 2
10 - Fully Willing
Row 0, Column 3
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What boundaries do you need to strengthen right now?
Huge
Large
Normal
Small
Ok
Ok
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What daily or weekly rhythms keep you grounded spiritually and mentally?
Huge
Large
Normal
Small
Ok
Ok
19
What systems or structures are missing from your life or business that keep you inconsistent?
Huge
Large
Normal
Small
Ok
Ok
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On a scale of 1–10, how consistent do you feel in your habits and stewardship?
1 = Inconsistent
Somewhat Satisfied
Satisfied
10 - Consistent & aligned
Service Quality
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Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Service Quality
1 = Inconsistent
Row 0, Column 0
Somewhat Satisfied
Row 0, Column 1
Satisfied
Row 0, Column 2
10 - Consistent & aligned
Row 0, Column 3
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What does “living in alignment” look like for you?
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Small
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Ok
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What do you most hope to experience or achieve through D.D.B. Coaching?
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Small
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Ok
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Which area do you need the most support in?
Clarity of purpose
Emotional healing
Spiritual maturity
Structure & accountability
Consistency & rhythm
24
How do you currently cultivate your relationship with God?
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Large
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Small
Ok
Ok
25
What’s your biggest fear about stepping into this next level?
Huge
Large
Normal
Small
Ok
Ok
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Are you ready to commit to this process with honesty, humility, and accountability?
Yes, I’m ready to steward my breakthrough
Not yet, but I’m close
27
Preferred coaching format:
1:1 Coaching
Group Cohort
Both
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Availability for sessions (days/times):
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Anything else you’d like to share before we begin?
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Small
Ok
Ok
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Should be Empty: