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GIRL SCOUTS OF THE PHILIPPINES NATIONAL HEADQUARTERS MANILA THE CHIEF GIRL SCOUT MEDAL SCHEME APPLICATION FORM I. PERSONAL INFORMATION Name ELVIE B. DELOS SANTOS Address: CAMBABANGAN, RIZAL, CAGAYAN Mobile/Tel. No. Troop No. 62 Region NORTHERN LUZON Council CAGAYAN Troop Leader MS. ELSA B. GALANG Parents MR. & MRS. ROGELIO DELOS SANTOS Occupation CARPENTER Registration Dates: 3 Years of Girl Scouting Experience Star Scout Junior Scout Senior Scout II. BADGEWORK (2 Badges for each of the 8 Point Challenge) BADGES EARNED CHALLENGE DATE EARNED God’s World Spirituality and Well Being June 2010 Friendship Spirituality and Well Being January 2011 Song Leader Arts January 2011 Literary Arts Arts March 2011 Recycling Environment February 2010 Eco-Good Turns Environment August 2010 Family Links Family Life December 2010 Me and my Family Family Life June 2010 Lifesaver & Outdoor Safety Preparedness April 2011 Home Nurse Preparedness April 2011 Community Service Heritage and Citizenship December 2010 Customs and Traditions Heritage and Citizenship August 2010 Money Management Economic Self- Sufficiency October 2010 Handicrafts Economic Self- Sufficiency July 2010 Harmony in Diversity World Community January 2011 Twinning World Community December 2010 III. CAMPING RECORD ENCAMPMENT DATE PLACE Troop Camp Oct. 30-31, 2009 Illuru National High Sch. School Council January 26-31,2010 Iguig, Cagayan Regional National

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Page 1: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

THE CHIEF GIRL SCOUT MEDAL SCHEMEAPPLICATION FORM

I. PERSONAL INFORMATIONName ELVIE B. DELOS SANTOSAddress: CAMBABANGAN, RIZAL, CAGAYANMobile/Tel. No. Troop No. 62Region NORTHERN LUZON Council CAGAYANTroop Leader MS. ELSA B. GALANGParents MR. & MRS. ROGELIO DELOS SANTOSOccupation CARPENTERRegistration Dates: 3 Years of Girl Scouting Experience Star Scout

Junior ScoutSenior Scout

II. BADGEWORK (2 Badges for each of the 8 Point Challenge)BADGES EARNED CHALLENGE DATE EARNED

God’s World Spirituality and Well Being June 2010Friendship Spirituality and Well Being January 2011Song Leader Arts January 2011Literary Arts Arts March 2011Recycling Environment February 2010Eco-Good Turns Environment August 2010Family Links Family Life December 2010Me and my Family Family Life June 2010Lifesaver & Outdoor Safety Preparedness April 2011Home Nurse Preparedness April 2011Community Service Heritage and Citizenship December 2010Customs and Traditions Heritage and Citizenship August 2010Money Management Economic Self-Sufficiency October 2010Handicrafts Economic Self-Sufficiency July 2010Harmony in Diversity World Community January 2011Twinning World Community December 2010

III. CAMPING RECORDENCAMPMENT DATE PLACE

Troop Camp Oct. 30-31, 2009 Illuru National High Sch.SchoolCouncil January 26-31,2010 Iguig, CagayanRegionalNational

IV. CHIEF GIRL SCOUT MEDAL SCHEME ORIENTATION /WORKSHOP July 24, 2011 NOTED : Submitted: ELSA B. GALANG ELVIE B. DELOS SANTOS

Troop Leader Candidate HELENA C. TUNGCUL

Council Executive

LAILA F. MORALES Regional Executive Director

Page 2: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILACGSMS Form No. 2

CHIEF GIRL SCOUT MEDAL SCHEMEPHASE 1 REPORT due EO SEPTEMBER

Name ANGELHYNE R. SIMONAddress BRGY. RAPULI, STA. ANA, CAGAYAN Mobile/Tel. No. Troop No. 560Region NORTHERN LUZON Council CAGAYANTroop Leader MS. MERELYN R. REPASO Target Community: PUROK LIMBUS,STA. ANA , CAGAYAN1. From the community problems/needs surveyed, select only one most pressing as recommended by the

community for your project: HEALTH DEVELOPMENT THROUGH INSTALLATION OF ONE UNIT JETMATIC PUMP 2. Area of Work (one only): HEALTH 3. Badgework

RELATED BADGES EARNED DATE EARNEDBADGES EARNED CHALLENGE DATE EARNED

The Word of God Spirituality and Well Being August 2010Leadership Building Spirituality and Well Being July 2010Performing Arts Arts September 2010Song Leader Arts September 2010Recycling Environment August 2010Ecologist Environment August 2010Me and My Family Family Life September 2010Family Adventure Family Life August 2010Public Safety Preparedness August 2010Lifesaver and Outdoor Safety Preparedness September 2010Customs and Traditions Heritage and Citizenship September 2010Community Service Heritage and Citizenship August 2010Plant Propagation Economic Self-Sufficiency August 2010Money Management Economic Self-Sufficiency September 2010Harmony & Diversity World Community July 2010International Linkage World Community September 2010

4. About the Project (use extra sheets)4.1 Project Description (attached) 4.4 Time Table (attached)4.2 Objectives (attached) 4.5 Budget (attached)4.3 Methods (attached)

5. Name of Consultants/beside the Troop Leaders (those who provide technical support to guide in objectives and congruency to the objectives)

5.1 Barangay Captain Tito Candelario 5.3 Parents of the Day Care Center pupils 5.2 Barangay Councilors 5.4 Mrs. Esperlita dela Cruz

6. Name/s of Work Group (Prospective CGSMS candidates but not those working already) SKs and other adults.6.1 Glydel Mateo 6.3 Glydel Gonzales 6.5 Casambalangan Students 6.7 Brgy. Officials and Community

6.2 Angelica Biggayan 6.4 Lovejoy Liquigan 6.6 BNS/SK Officials 7. References (attach list of titles/topics related to the project –at least 3)

7.1 Encyclopedia of Knowledge Readings7.2 Desk Reference Encyclopedia Ecology7.3 Bible Spiritual Readings

8. From the readings in no. 7 how did you apply the learning or insights gained in your project? (use extra sheets/s) attached copy

NOTED : Submitted: MERELYN R. REPASO ANGELHYNE SIMON

Troop Leader Candidate HELENA C. TUNGCUL

Council Executive

LAILA F. MORALES Regional Executive Director

Page 3: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

CGSMS Form No. 3CHIEF GIRL SCOUT MEDAL SCHEME

PHASE 2 REPORT due EO October

Name IVY JEAN MARGAREJOAddress RAPULI,STA. ANA CAGAYAN Mobile/Tel. No. Troop No. 022Region NORTHERN LUZON Council CAGAYANTroop Leader MS. MARGARITA G. CALIVA

1. Self-Development Skills Acquired and Practiced (at least 3 useful skills)1. Leadership2. Motivating people to support a project 3. Human Relations

2. Spiritual Readings (How did you apply the learnings gained from your spiritual readings in your project? At least 5)

1. Trust in God2. Faith on Yourself/Self-Confidence3. humility and Acceptance of the truth 4. Prayer is the best weapon against any obstacle in life5. Patience and perseverance helped me a lot in the implementation of my project.

3. Spiritual Advisers/s Name/s Dates of Counseling

Rev. Father Virgilio Mendoza December 2010 Rev. Father Domingo Resurrecion September 2010

4. Networking (list the name of Agencies/Organizations networked with)

1. Local Government Unit of Sta. Ana2. Barangay Council of Rapuli3. Sitio punti Residents4. SK Officers5. Casambalangan National High School

Submitted by: IVY JEAN MARGAREJO Candidate

Noted by: MARGARITA G. CALIVA Troop Leader

HELENA C. TUNGCUL Council Executive

LAILA F. MORALES Regional Executive Director

Page 4: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

CGSMS Form No. 4CHIEF GIRL SCOUT MEDAL SCHEME

PHASE 3 IMPLEMENTATION REPORT due EO June

Name LOVEJOY TEJANOMobile/Tel. No. Troop No. 022Region NORTHERN LUZON Council CAGAYANTroop Leader MS. MARGARITA G. CALIVA

1. Work Done Dates Activities Undertaken Persons Involved(use separate sheets)PLANNING August 2010 Information/Dissemination Brgy. Officials

CGSMS CandidateTroop Leader

IMPLEMENTATION Sept, 2010 Putting up Brgy. Veg. Garden CGSMS Candidate March 2011 Planting of veg. seedling Residents, Barangay

Dispersal of veg. seedlings OffcialsPainting of GSP Signage SK Members

2. Meetings with Date of Meeting Results of Meeting*Brgy. Officials September 2010 Agenda well taken* Work Group with Troop Leader September 2010 Agenda well taken* Monitoring Panel 1. ________________________________

2. ________________________________3. ________________________________

Others (specify) Council Staff School CoordinatorBarangay Officials

3. Date of Visits of the Monitoring Panel

3.1 March 2011 and May 2011

4. Observations of the Monitoring Panel (attach copies of observations)_________________________________________________________________________________

attached copy_________________________________________________________________________________

Submitted by: LOVEJOY TEJANO Candidate

Noted by: MARGARITA G. CALIVA Troop Leader

HELENA C. TUNGCUL Council Executive

LAILA F. MORALES Regional Executive Director

Page 5: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

CGSMS Form No. 4CHIEF GIRL SCOUT MEDAL SCHEME

PHASE 3 IMPLEMENTATION REPORT due EO June

Name IVY JEAN MARGAREJOMobile/Tel. No. Troop No. 022Region NORTHERN LUZON Council CAGAYANTroop Leader MS. MARGARITA G. CALIVA

1. Work Done Dates Activities Undertaken Persons Involved

ATTACHED COPY__________________ ___________ ______________________ ____________________________________ ___________ ______________________ __________________

2. Meetings with Date of Meeting Results of MeetingBarangay Officials September, 2010 ApprovedTroop Leader & Sch. Principal July 2010 Approved Others: Council Staff

GSP CoordinatorsBarangay Officials

3. Date of Visits of the Monitoring Panel3.1 April 1, 2011 3.2 May 6 , 2011

4. Observations of the Monitoring Panel (attach copies of observations) SEE ATTACH COPY

Submitted by: IVY JEAN MARGAREJO Candidate

____________________________ Date

Noted: MARGARITA G. CALIVA Troop Leader

HELENA C. TUNGCULCouncil Executive

LAILA F. MORALES Regional Executive Director

Page 6: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

CGSMS Form No. 5CHIEF GIRL SCOUT MEDAL SCHEME

ACCOMPLISMENT REPORT due EO June

Name IVY JEAN MARGAREJOMobile/Tel. No. Troop No. 022Region NORTHERN LUZON Council CAGAYANTroop Leader MS. MARGARITA G. CALIVA

1. Summary of the Project1.1 Narrative Report of Accomplishment (due extra sheets as needed)

ATTACHED COPY_____________________________________________________________________________

1.2 Effects on the:Community ATTACHED COPY

Candidate ATTACHED COPY

2. Turn-Over Ceremony (Attach copy of the Program)Place Rapuli Barangay Hall, Sta. Ana, CagayanDate: June 17, 2011

3. List of Persons Recognized/Appreciated Assistance Received1. Mayor & Mrs. Darwin Tobias Financial 2. Brgy. Captain Tito Candelario Financial3. Barangay Council Financial4. Mr. & Mrs Jonas Margarejo Financial and Moral Support5. Residents of Brgy. Rapuli Moral Support6. Brgy. Kagawad Ronie Olandiz Lot Donor

4. Plans for sustaining the Project ATTACHED COPY

Submitted by: IVY JEAN MARGAREJO Candidate

Noted by: MARGARITA G. CALIVA Troop Leader

HELENA C. TUNGCUL Council Executive

LAILA F. MORALES Regional Executive Director

Page 7: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

CGSMS Form No. 5CHIEF GIRL SCOUT MEDAL SCHEME

ACCOMPLISMENT REPORT due EO June

Name JONA LIZA S. RAGUINGAN Region NORTHERN LUZON Council CAGAYANTroop Leader MRS. ROSALIE P. LUGO Troop No. : 061

1. Summary of the Project1.1 Narrative Report of Accomplishment (due extra sheets as needed)

attached copy____________________________________________________________________________________________________________________________________________________________

1.2 Effects on the:Community

Attached copy____________________________________________________________________________________________________________________________________________________________Candidate

attached copy____________________________________________________________________________________________________________________________________________________________

2. Turn-Over Ceremony (Attach copy of the Program)Place: Barangay Hall, Buntun, Tuguegarao CityDate: June 5, 2011

3. List of Persons Recognized/Appreciated Assistance Received(use extra sheets) attached copy

4. Plans for sustaining the Projectattached copy

______________________________________________________________________________________________________________________________________________________________

Submitted by JONA LIZA S. RAGUINGAN Candidate

____________________________ Date

Noted: ROSALIE P. LUGOTroop Leader

HELENA C. TUNGCULCouncil Executive

LAILA F. MORALES Regional Executive Director

GIRL SCOUTS OF THE PHILIPPINES

Page 8: CGSMS Phase Forms

NATIONAL HEADQUARTERSMANILA

THE CHIEF GIRL SCOUT MEDAL SCHEMEEvaluation Form

Name : DEVINE LAUREINE FULGENCIO Council : CAGAYAN Region NORTHERN LUZON Troop Leader : MRS. SHIRLEY F. LORENZO Troop Number: ____Area of Work : HEALTH Period Covered: July 2010 – June 2011

CRITERIA FOR EVALUATION

I. PERSONAL ATTRIBUTES 30% (to be rated by the Troop Leader)Adequate Progress and Growth in: RATINGa. Spiritual and Physical Health _________b. Integrity _________c. Sense of Responsibility _________d. Perseverance, Effort & Determination _________e. Manners and Decorum _________f. Knowledge and Skills _________g. Poise and Grooming _________

Name & Signature of Troop Leader: JOYCE D. SUBOC II. PERFORMANCE 40% (to be rated by the Panel of Evaluators)

a. LEADERSHIP _________- Planning- Organizing

b. IMPLEMENTATION _________- Follow through of plans- Networking- Use of Resources

c. DOCUMENTATION _________- Completeness of records (neatness, organization & presentation of thoughts, presence

of required documents)III. THE PROJECT 30%

A. COMMUNITY INVOLVEMENT _________B. EFFECT ON: _________

- Community- Candidate

C. SUSTAINABITY _________TOTAL _________

Remarks: A percentage of 80 %to 100% to qualify the candidate for the Chief Girl Scout Medal

Evaluated: ____________________

Date ____________________

Noted LAILA F. MORALESRegional Executive Director

Page 9: CGSMS Phase Forms

GIRL SCOUTS OF THE PHILIPPINESNATIONAL HEADQUARTERS

MANILA

THE CHIEF GIRL SCOUT MEDAL SCHEMESummary of Rating

Name : ANGELHYNE R. SIMONCouncil : CAGAYAN Region NORTHERN LUZON Troop Leader : MS. MERELYN R. REPASO Troop Number : 560Area of Work : HEALTH : INSTALLATION OF ONE UNIT JETMATIC PUMP

NAME OF EVALUATOR POSITION SIGNATURE RATING

1. Outstanding Citizen

2. Outstanding Citizen

3. LORNA B. MANAUIS, Ph.D. Council Commissioner on Program

4. HELENA C. TUNGCUL Council Executive

5. Regional Representative

AVERAGE ____________________

Evaluated : ___________________________

___________________________ Position

Noted LAILA F. MORALES Regional Executive Director

Page 10: CGSMS Phase Forms

COMMUNITY PROFILE

1. Name of Purok/Zone Population2. Barangay Municipality/Provincial/City: 3. No. of Families in the Purok No. of Interviewed 4. No. of Houses: Light Materials Concrete5. No. of Houses with:

Toilets ElectricityRunning Water Artesian WellFlower Garden Vegetable Garden Poultry Piggery

6. No. of schools/in the purok/zone7. No. of church/chapel in the purok/zone8. Government offices located in the purok/zone9. No. of hospital/clinic in the purok/zone10. Community centers available like day care, reading, health centers, others (specify) in the

purok/zone11. Means of transportation available in the purok/zones 12. Recreational facilities available in the purok./zone13. Means livelihood/occupation/employment of the people in the purok/zone14. Educational attainment of the (indicate number)

In school Out of School

15. No. of school children of school age (6yrs. -21 yrs)

Men : Elementary High school Degree HolderWomen: Elementary High school Degree Holder

16. General condition of:

Roads Drainage : Park Plaza/trees & other plants : Market Garbage disposal : Compost pit

17. Persons Interviewed

18. Identified three (3) community problem/needs1. Communal Garden2. Trees3. Garbage Disposal

Carmela bian CGSMS Candidate

Noted: JOYLIN C. CORTES Troop Leader

Page 11: CGSMS Phase Forms

REPUBLIC OF THE PHILIPPINESDEPARTMENT OF EDUCATION

REGION 02DIVISION OF CAGAYAN

BAUA NATIONAL HIGH SCHOLGONZAGA , CAGAYAN

INSTALLATION OF ONE UNIT JETMATIC PUMP WATER SYSTEM PUROK 06, SAN JOSE, GONZAGA, CAGAYAN

PROJECT EXPENDITURES:

A. EXPENDITURES

1 unit jetmatic pump and accessories--------------------- P2,50011 bags cement------------------------------------------------------ P2,730100 pcs hallow blocks----------------------------------------------- P1,310¼ load gravel and sand -------------------------------------------- P8104 pcs GI sheet 6 ft--------------------------------------------------- P6405 pcs 1 ¼ pvc--------------------------------------------------------- P6404 pcs 10 mm rod----------------------------------------------------- P6101 liter latex paint (white)------------------------------------------ P1801 liter latex paint (green)----------------------------------------- P180¼ liter latex paint (red)------------------------------------------ P602 kilos assorted nails---------------------------------------------- P120½ kilos umbrella nails--------------------------------------------- P602 pcs elbos----------------------------------------------------------- P80

Total ------------------- P9,800

Page 12: CGSMS Phase Forms

FINANCIAL STATEMENT

Name of the Project :COCONUT TREE PLANTING AREA OF WORK :ECOLOGY Address : Barangay Cabiraoan, Gonzaga, Cagayan

1. SOURCES OF FUNDSCash on Hand P16,880.00

Solicitations P12,000.00

Donations 4,880.00

2. Less: EXPENDITURES

ITEM DESCRIPTION QUANTITY UNIT COSTPortland cement 6 bags 1,500.00Paint 2 gallons 1,000.00Assorted nails 5 kgs. 500.00Lumber 2x3x8 20 pcs. 2,500.00Concrete hollow blocks 100 blks. 1,000.00Ridge roll 1 pc. 220.00Gasoline 2 gals. 200.00Coconut seedlings 300 pcs. 1,500.00

Sub Total

3. TOTAL CASH BALANCE P - - - 0 - -

Page 13: CGSMS Phase Forms

LIST OF DONORS

NAME AMOUNT

Cong. Jack Enrile P2,700.00

LGU of Sta. Teresita 1,500.00

Sta. Teresita Nat’l. HS 1,000.00

Brgy. Council of Dungeg 1,000.00

Mrs. Edna Valdez 5,000.00

OFW 2,000.00

Friends & Relatives 3,600.00

TOTAL P 16,800.00

Page 14: CGSMS Phase Forms

LEARNINGS BASED ON THE RESEARCH TOPICS:

COMMUNICATION I learned that the appropriate use of varied communication techniques and

strategies to helped a lot in the accomplishment of various tasks to be done with the project.

I learned that smile promotes positive reactions when discussing with group of individuals about the project.

I learned that one could find more significant meaning in life when we can communicate well due to lesser misunderstanding.

COMMUNITY DEVELOPMENT Implementing the Girl Scout program in the community helped me gain a

strong determination to succeed. I learned that introducing a community project to the people gave me the

chance to win friends and become a model. I learned that self-discipline is needed to attain my goal.

HUMAN RELATION I learned that it is nicer to call people by their name. They respond with good

mood immediately. I learned that creating humorous words helps me finish my project.

Being courteous to people helps me finish my project.

Page 15: CGSMS Phase Forms

OBSERVATION OF THE MONITORING PANELS

TROOP LEADER:The candidate must visit her project regularly.

BARANGAY OFFICIALSThe candidate should coordinate to the Barangay Council whatever problems/needs with regards to the development of her project.

COUNCIL HEADQUARTERS:That the project site should maintain its cleanliness especially that it is beside the Barangay Day Care Center;

That the site of the project must be beautified too;

Ask the assistance of the Municipal Health Officer to test the notability of the source of water;

Page 16: CGSMS Phase Forms

EFFECT ON THE PROJECT

BARANGAY OFFICIALS

The said project became an eye opener to the officials of Buntun, as well as the SK Officers and members that proper disposal of waste plays a vital role in reducing the cases of insect-caused diseases specially mosquitoes.

COMMUNITY

People of Buntun realized that proper waste disposal does not only reduces diseases but it also beautifies the community because since the day the project was implemented, garbage hang in fences before the collection of garbage was being minimized in which before this scenario was an eyesore to the community.

CANDIDATE

This project has taught me to become a responsible leader in my own. It made me realized that as a senior scout, I have a very great role in the promotion of the “Clean and Green Program” of the government .

WORK ACTIVITIES

FRAME WORK ACTIVITIES DATES PERSONS INVOLVED

Page 17: CGSMS Phase Forms

PLANNING Information/Dissemination to the School Principal/Barangay Officials and Purok Leaders

Attend CGSMS Orientation and Community Survey

Submit Application Letter to Council Headquarters at Tuguegarao City

July to August 2010

CGSMS Candidate/Troop Leader/School PrincipalBarangay Officials/Council Executive

ORGANIZING Attend Barangay Council Meeting with the Barangay Captain and his Council

Organize Networking Groups with different clubs in the barangay

August to September 2010

CGSMS Candidate/Troop Leader/School PrincipalBarangay Officials/Community

IMPLEMENTATIONCleaning the proposed project site with the helped of the Barangay Officials and some community members

Procurement of the needed materials

Installation of the pump and kiosk

Maintain Cleanliness and beautification

Work on CGSMS logbook

September 2010

to

May 2011

CGSMS Candidate/Troop Leader/Barangay Officials/CommunityDay Care Teacher

FINALIZATION/COMPLETION EVALUATION OF THE PROJECT

Council VisitationRegional EvaluationTurn Over of ProjectSubmission of

January 2011toJune 2011

Sch. GS CoordinatorBarangay Officials Council StaffRegional Staff

MONTHLY ACCOMPLISHMENT

Page 18: CGSMS Phase Forms

JULY 2010Miss Margarita Caliva, our Troop Leader conducted a troop meeting.

AUGUST 2010We attended the CGSMS Orientation Workshop which held in our school. Also, we informed our School Principal about our intent to join in the Chief Girl Scout Medal Scheme project.

We also visited the office of the Barangay Captain and informed him about the Program Thrusts project of the Girl Scouts of the Philippines, the Chief Girl Scout Medal Scheme.

Together with my fellow candidates, we have a community survey in our respective puroks.

Submitted an application form to the Council Headquarters.

SEPTEMBER 2010

We attended the Barangay Council Meeting at the Barangay Hall . And we presented to them the result of our survey. The Barangay Captain told us it was their problem too because the community folks are hard up in fetching potable water in their place.

We organized our networking group to work with me in realization of my project. We cleaned the project site and removed tall grasses in the project site.

I also submitted my research topic to my troop leader for editing. And I also had my spiritual guidance from a lay leader.

OCTOBER 2010On this month, my troop leader drafted a solicitation letter signed by our principal.

Through the money we raised from our solicitation, we procure the needed materials ready for the installation of one unit jetmatic pump.

Started working on my CGSMS documents.

NOVEMBER 2010

Page 19: CGSMS Phase Forms

The Barangay Officials and some members of the community folks started to work on my project. The members of the team removed the dirty water inside the well to make it suitable and safe for drinking. They cover the well to prevent it from contaminated object. Then, they place a pvc tube from the well to the jetmatic pump.

DECEMBER 2010My troop leader assists me in making my logbook and ready for the pre-evaluation. I gather impressions from the residents with regards to my project.

JANUARY 2011The community residents installed the jetmatic pump. We also clean the surroundings.

FEBRUARY 2011Continue cleaning the surrounding with the help of my fellow scouters and residents of the community.

MARCH 2011The Council Staff visited my project and give some recommendation for the betterment of my project.

April 2011The beneficiaries of my project help in building the kiosk and beautified the

surroundings by planting of ornamental plants.

MAY 2011Evaluated my project by the Regional Staff headed by the Regional Executive Director Ms. Laila F. Morales last May 6, 2011.

JUNE 2011Turned over the project to the Barangay Council of Casambalangan.

Submitted my CGSMS logbook.

Page 20: CGSMS Phase Forms

TURN OVER PROGRAMMEJUNE 1, 2011

DUNGEG BARANGAY HALLDUNGEG, STA. TERESITA, CAGAYAN

PROGRAMME

Invocation ---------------------------------------------- ANGELICA ANDAYA Senior Girl Scout

Pambansang Awit------------------------------------ Harritte Quimby Tibuc

Barangay Secretary

Opening Remarks----------------------------------- MS. CZARINA MAE PAGADOR

SK Chairman

Turn Over Speech---------------------------------- PREXCEEH ANGELA VALDEZ

CGSMS Candidate

Acceptance Speech--------------------------------- HON. AVELINO SOBRERA

Barangay Captain

Impressions:VIOLETA TABASANB.N.S.

NESSIE TACTAC Brgy. Kagawad

Response------------------------------------------ PREXCEEH ANGELA VALDEZ

CGSMS Candidate

Parting Shots-------------------------------------- TORQUIANO PALOR Barangay Kagawad

Lady of Ceremony:

Page 21: CGSMS Phase Forms

MARY JANE TACTACBarangay Secretary

TURN-OVER SPEECH DELIVERED BY SENIOR SCOUT PREXCEEH ANGELA M. VALDEZ

CHIEF GIRL SCOUT MEDAL SCHEME CANDIDATE

To our ever supportive Barangay Officials, our School Principal, Troop Leaders and my fellow candidates for the Chief Girl Scout Medal Scheme, benefactors and to everyone around, good morning.

I was in my first year when I first heard about the Chief Girl Scout Medal Scheme and yes, I wanted to be a candidate and to be a medalist, with my belief of the Girl Scout Promise and Law. I decided to join the scheme.

Purok 1 – The Core Shelter of Barangay Dungeg is a place where I decided to put up my project. I know that the people living in this area need my help. And I’m blessed that through the help of some civic minded individuals, my project was accomplished.

From there, I then realized that my simple contribution and vision will serve as an inspiration not only to the youth but to all the people who will open their heart in community services.

With the implementation of my project, I want to express my utmost thanks for your cooperation and help. To the benefactors who are here with us, thank you for being the blessings in this project, to the Barangay Captain along with his council, Sir, I now turn over to you my project; please take good care of the project. Let it be an accomplishment for all of us.

Thank you to all the people who have helped me finish this project.

Page 22: CGSMS Phase Forms

God Bless us all ! ! !

At the outset allow me to greet you a pleasant day most especially to our visitors and of course the Girl Scouts of the Philippines Troop Leaders and the Chief Girl Scout Medal Scheme candidates of Sta. Teresita National High School through the leadership of our school principal Mrs. Nympha Alagao and School GS Coordinator Ms. Rose M. Macapulay. Whom we owed unmeasurable help by giving us this project which is very useful most especially to the people of Purok 1 – Core Shelter.

In behalf therefore of the Dungeg Barangay Officials and by the power vested in me as the Barangay Chairman I, Barangay Chairman Avelino Sobrera now accept this project INSTALLATION OF ONE UNIT JETMATIC PUMP” with much gratitude for giving us the project. WE promised you that we will take good care of it through the years.

Once again, thank you and Mabuhay tayong lahat.

Page 23: CGSMS Phase Forms

Republic of the PhilippinesProvince of Cagayan

Municipality of Sta. AnaBarangay Rapuli

OFFICE OF THE SANGGUNIANG BARANGAY

PLANS FOR SUSTAINING THE PROJECT

The following are the plans for sustaining the project implemented by Senior Girl Scout ANGELHYNE R. SIMON at Day Care Center, Purok Limbus, Brgy. Rapuli, Sta. Ana, Cagayan:

Make a memorandum of agreement to be signed by all beneficiaries to maintain and sustain the project.

Draft an ordinance to safeguard the project so that it will be maintained and sustained. Allot an amount from our IRA for its maintenance.

As the Chairman of this barangay, I hereby commit myself for the sustainability of the project implemented in our locality .

Signed this 5th day of June, 2011.

TITO CANDELARIOBarangay Captain

Page 24: CGSMS Phase Forms

TABLE OF CONTENTS

CGSMS FORM 1a. Chief Girl Scout Medal Scheme Application Form b. Endorsement Letters c. Community Profile d. Form 1-A Worksheet #1 Problem/Opportunity Analysis e. Form 1-A Worksheet #2 Problem Design Checklist

CGSMS FORM 2a. Project Description b. Objectives c. Methods d. Action Plan e. Financial Budget f. Leanings Gained in the Research Work

CGSMS FORM 3a. Spiritual Readings b. Learnings on Spiritual Readings

CGSMS FORM 4a. Minutes of the Meetings b. Observations of the Monitoring Panel

Page 25: CGSMS Phase Forms

CGSMS FORM 5a. Narrative Report of Accomplishment b. Effects on the Community and Candidate c. Turn-Over Ceremony Programme d. List of Persons Recognized e. Plans for Sustaining the Project f. Monthly Accomplishment of the Project g. Problems Met and Solutions h. Impressions i. Correspondence j. List of Beneficiaries k. Pictorials

CGSMS FORM 6a. Evaluation Forms