CGSMS Forms

Girl Scouts of the Philippines
NORTHERN LUZON REGION
ILOCOS NORTE-LAOAG COUNCIL
CHIEF GIRL SCOUT MEDAL SCHEME

First Name: MAUREEN JOY
Family Name: ESPIRITU
Troop Number:
School: DUMALNEG NATIONAL HIGH SCHOOL
MI: C.
Troop Leader: JOLLY MAR T. MANGILAYA

Parents: MR. & MRS. JUNALD ESPIRITU
Ecology
Livelihood
Project:
Health
Cultural Heritage
Date of Project Started

Project Site
Workgroup
Children
No. of Beneficiaries
Families
Others
Summary of Project to show the different stages of the project implementation:

Pre-planning:
Planning:
Implementation:
Turning over of projects to the community leaders:
Evaluation:
Preparation of reports:
Personal experience/s, significant contributions to the community and the lessons learned in carrying
out the project:
Submitted by:
MAUREEN JOY C. ESPIRITU
Candidate
Noted by:
JOLLY MAR T. MANGILAYA

Troop Leader
MARINA M. REYNON
Council Executive
LAILA F. MORALES
Regional Executive Director
Girl Scouts of the Philippines

ILOCOS NORTE-LAOAG COUNCIL

Monthly Project Report
Name
Project
CONSTRUCTION OF VEGETABLE GARDEN AT SITIO LAGUERTA, SAN ISIDRO,
Troop No.
DUMALNEG, ILOCOS NORTE
Troop Leader
Year
MISS JOLLY MAR T. MANGILAYA
Month
July
August
September
2015
October
November
December
2016
January
Accomplishment
Remarks
February
March
April
May
June
GIRL SCOUTS OF THE PHILIPPINES

ILOCOS NORTE LAOAG COUNCIL
CGSMS Form No. 1
APPLICATION FORM
I. PERSONAL INFORMATION
: MAUREEN JOY C. ESPIRITU____________________________________________________
: SAN ISIDRO, DUMALNEG, ILOCOS NORTE________________________________________
: 09996783924_________________
Troop No.________________________________
: Ms. JOLLY MAR T. MANGILAYA____________________________________
: Mr. JUNALD ESPIRITU
Occupation
: Farming__________
Mrs. MARLYN ESPIRITU
Occupation
: Housekeeping_____
Registration Date: September 26, 2013
August 30, 2014
August 15, 2015
Three (3) Years of Girl Scouting Experiences:
Inter-troop Camps______________________________________________________
Thinking Day Celebrations______________________________________________
Senior Saranay Camps__________________________________________________
Regional Encampments_________________________________________________
Name
Address
Contact No.
Troop Leader
Parents
II. BADGEWORK
(2 badges for each of the 8 Point Challenge)
Badges Earned
Challenge
Date Earned
1. Money Management
Challenge of Economic Self-Sufficiency
November 2013
2. Handicrafts
Challenge of Economic Self-Sufficiency
October 2012
3. Eco Good Turns
Challenge of the Environment
October 2013
4. Recycling
Challenge of the Environment
October 2012
5. Public Safety
Challenge of Preparedness
October 2013
6. Personal Safety
Challenge of Preparedness
November 2013
7.
Challenge of Heritage and Citizenship
October 2012
8. Chronicler
Challenge of Heritage and Citizenship
September 2012
9. Terpsichorean
Challenge of the Arts
September 2012
10. Performing Arts
Challenge of the Arts
October 2013
11. Friendship
Challenge of Spirituality and Well-Being
November 2013
12. A Look at Myself
Challenge of Spirituality and Well-Being
September 2012
13. Me and My Family
Challenge of Family Life
October 2013
14. Family Links
Challenge of Family Life
September 2013
15. Harmony in Diversity
Challenge of World Community
November 2013
16. Twinning
Challenge of World Community
September 2012
Customs and Traditions
III. CAMPING RECORD

Encampment
Date
Place
Troop
Inter-Troop Camp
November 06-08, 2014
Bangui NHS
Council
Seniors Saranay
November 14-16, 2014
D&D by the Sea
Regional Encampment
December 04-07, 2014
Subic, Zambales
Regional
IV. CHIEF GIRL SCOUT SCHEME ORIENTATION/WORKSHOP

Date: July 25, 2015
Place: Council Headquarters
Submitted by:
Candidate
Noted by:
Troop Leader
Attachments:
1. Troop Leaders Endorsement
2. Parents Endorsement
3. Community Profile
MARINA M. REYNON
Council Executive
LAILA F. MORALES
NATIONAL HEADQUARTERS
MANILA
CGSMS Form No. 2
PHASE 1 REPORT due EO SEPTEMBER
Name
Address
: San Isidro, Dumalneg, Ilocos Norte________________________________________
Contact No.
: 09996783924_________________
Troop No.
:__________________________
Council
: Ilocos Norte-Laoag______
Region
: Northern Luzon
Troop Leader : Ms. Jolly Mar T. Mangilaya___________________________________________________
Target Community
: Sitio Laguerta, Bgy. San Isidro, Dumalneg, Ilocos Norte
1. From the community problems/needs surveyed, select only one most pressing as recommended by the
community for your project. CONSTRUCTION OF A VEGETABLE GARDEN AT SITIO LAGUERTA,
SAN ISIDRO, DUMALNEG, ILOCOS NORTE
2. Area of Work : HEALTH
3. Badgework
Related Badges Earned
Dates Earned
1.
Money Management
November 2013
2.
Eco Good Turns
October 2013
3.
Recycling
October 2012
4.
Friendship
November 2013
5.
A Look at Myself
September 2012
6.
Harmony in Diversity
November 2013
4. About the Project

4.1 Project Description
The vegetable garden will be situated at Purok Laguerta, Bgy. San Isidro, Dumalneg, Ilocos Norte.
Different kinds of vegetables such as gourd, tomato, eggplant, squash, okra, string beans, malunggay,
papaya, bell pepper and others will be grown in the area.
4.2 Objectives
To respond to the most pressing need of the community
To provide a good source of healthy vegetables for the residents
To highlight the importance of eating healthy, clean, and fresh vegetables
To increase peoples awareness on the significance of maintaining a vegetable garden
at home
4.3 Methods
Inform barangay officials about the project.
Consult other concerned individuals and government agencies for their
recommendations in the implementation of the project.
Establish linkages with the community folks and people that could be of help in the
realization of the project.
Carry out planned activities recorded in the time table.
4.4 Time Table
Month
Activities
July
August
Take a council orientation on the scheme.

Conduct a survey on the needs/problems of the community.
Collect further information on the identified needs of the community through visits,
interviews, and consultations with community leaders and other residents.
Start designing plan of action.
Attend barangay meetings and sessions for further discussions regarding the project.
Identify the government agencies or NGOs to network with.

Finalize plan of action (objectives and time table).
Discuss project proposal with the different groups which could support in the making of
the project.
Read about topics on putting up a vegetable garden and vegetable production.
October
Take up a skill which could be of help in the chosen project.

Undertake spiritual counseling.
Start distributing solicitation letters.
November
Start preparing the area for the propagation and planting period.
Continue distributing solicitation letters.
Conduct weekly clean-up drives.
Conduct weekly clean-up drives.

Carry on the distribution of solicitation letters.
Work on ways on how to further cultivate and improve the area for planting.
Dig holes to be used for composting.
January-March
Plant prepared seeds and cuttings.

Cultivate the planted vegetables.
Maintain cleanliness of the area.
April-June
Sustain the cleanliness of the area.

Further cultivate the plants.
Turn-over the project to the community.
September
December
4.5 Budget
I.
II.
Expected Income
Estimated Expenses
Seeds and Cuttings
Organic fertilizer
Insecticide
Snacks
:
:
PhP 6000.00
PhP 6000.00
PhP 3000.00
PhP 1000.00
PhP 1000.00
PhP 1000.00
TOTAL
PhP 6000.00
5. Name of Consultant/s beside the TL (Those who provide technical support to guide in objectives formulation
and congruency of activities to the objectives)
5.1 Hon. Lairvee G. Espiritu
5.2 Hon. Francis R. Espiritu Jr.
5.3 Brgy. Capt. Oscar Agreda, Jr.
5.4 Kag. Romualdo Balalio
5.5 Kag. Jerry Balalio
5.6 Kag. Wilson Cascayan
5.7 Kag. Freddie Suniga
5.8 Kag. Rogelio Balalio, Jr.
5.9 Kag. Roland Soriano
5.10
Kag. Benjamin Suniga
5.11
Mr. Gerardo Botulan
5.12
Dr. Rizalde Acosta
5.13
Mr. Wilfredo Nonesa
5.14
Mr. Victor Dabalos
6. Names of Work Group (Prospective CGSMS candidates but not those working already) SKs and other adults
6.1 Sr. Sct. Rebecca Agpaoa
6.12 Sr. Sct. Rosel Ann Dalere
6.2 Sr. Sct. Jellie Ann Miguel
6.13 Sr. Sct. Dezyre Jenwynne Aguinaldo
6.3 Sr. Sct. Febie Alfonso
6.14 Sr. Sct. Jessica Suniga
6.4 Sr. Sct. Charymelle Domingo
6.15 Sr. Sct. Crizzia Mae Suniga
6.5 Sr. Sct. Angelica Sapngad
6.16 Sr. Sct. Jenjay Dalere
6.6 Sr. Sct. Feona Corina Agoo
6.17 Mr. Alden Suniga
6.7 Sr. Sct. Shyne Alyssa Maruquin
6.18 Mr. Modesto Rivera
6.8 Sr. Sct. Charelle Domingo
6.19 Mr. Michael Subia
6.9 Sr. Sct. Arian Klei Suniga
6.20 Mr. Jerold Suniga
6.10 Sr. Sct. Regine Guerrero
6.21 Mr. Abelino Nieto
6.11 Sr. Sct. Ronalyn Espartero
6.22 Mr. Juanito Domingo
7.
References (Attach list of titles/topics related to the Project (at least 3)
8.
Name of Book
Topic/Title Read
9.
7.1 Agricultural Crops Production
Land Preparation on Vegetable Production
10.
7.2 Technology and Livelihood Education
Planting and Fertilizer Application
11.
7.3 Vegetable Production Guide for Commercial Growers
General Production Considerations
12. From your readings in No. 7, how did you apply the learnings or insights gained in your project?
13.
From the readings I had, I applied the learnings and insights I gained through incorporating
them in designing my time table and planning for the appropriate activities (propagation, fertilizer
application, etc.) which I will be doing every month.
14.
15.
16.
Submitted by:
17.
18.
19.
20.
Candidate
Noted by:
21.
22.
September 26, 2015
23.
24.
Troop Leader
26.
27.
28.
25.
MARINA M. REYNON
Council Executive
29.
LAILA F. MORALES
30.

31. GIRL SCOUTS OF THE PHILIPPINES
32. NATIONAL HEADQUARTERS
33. MANILA
34.
35. CGSMS Form No. 3
36.
37. CHIEF GIRL SCOUT MEDAL SCHEME
38.
PHASE 2 REPORT due EO OCTOBER
41.
42.
43.
44.
45.
Name
Council
Troop No.
39.
40.

: Ilocos Norte-Laoag________________ Region
: Northern Luzon
: _________________________________ Troop Leader : Jolly Mar T. Mangilaya___________
1. Self-Developmental Skills Acquired and Practiced

46.
1.1 Plant Propagation

47.
I developed my skill in determining which propagating techniques are effective and suitable
for vegetables such as okra, taro, squash, onion, malunggay, papaya, and others which we will be
planting on the garden.
1.2 Gardening
48.
Putting up a vegetable garden requires a skill on gardening. I learned the ways on
determining which kind of soil is right for which kind of vegetable, applying plastic mulch on plant beds,
cultivating plants for them to grow healthy and preparing organic pesticides and fertilizers.
1.3 Computer Work
49.
This project also demands a skill on manipulating the computer. I harnessed my skill in
working on different computer applications such as Microsoft Word, Microsoft Excel, Microsoft
PowerPoint, and Microsoft Paint for the preparation of my forms and communications, budget,
presentations and garden lay-out. I also learned more on information gathering through searching the
Internet and other sources for my project.
50.
2. Spiritual Readings
51.
2.1 Luke 6:31

52.
Do to others as you would have them do to you.
A girl scout is helpful. It is my sworn duty as a girl scout to render service to the community
without expecting anything in return. After identifying the 3 most pressing needs of my folks, I felt the
strong desire to be of help to them in the simplest but best way I can.
53.
54.
2.2 Psalm 133:1
55.
Behold, how good and how pleasant it is for brethren to dwell together in unity.
56.
Undertaking the Chief Girl Scout Medal Scheme Project (CGSMSP) is never considered as a
walk in the park. Lots of things are needed to be accomplished on time. But I am confident that the
project will be realized with the help of my community folks and with the unending support of my
parents, the Local Government Unit of Dumalneg, Barangay and Purok Councils and other stakeholders.
57.
59.
2.3 Proverbs 3: 25-26

58.
Have no fear of sudden disaster or of the ruin that overtakes the wicked, for the Lord will be
at your side and will keep your foot from being snared.
In undertaking this project, I learned to be optimistic at all times. Whatever unexpected
situations and challenges I may encounter in undergoing my project, there will be no place for fear
because I know that God will guide my steps along the way.
60.
2.4 Colossians 3:23
61.
Whatever you do, work at it with all your heart, as working for the Lord, not for human
masters.
Working on my project entails sincerity and dedication. Even at a very young, I know that I
can instigate positive change in my community. I therefore commit myself in catering the need of the
community for a garden as a free source of healthy and fresh vegetables. All glory and honor will be
given back to the Lord because He is the source of everything.
62.
63.
2.5 Proverbs 10:4
64.
Lazy hands make for poverty, but diligent hands bring wealth.
65.
Community service, as the battlecry of the GSP Movement, is a test of effective networking,
leadership, perseverance, and industry. As a CGSMS Candidate, I diligently work on the requirements of
my project like forms, letters, networking strategies and in the actual preparation of the vegetable
garden.
66.
67.
68.
69.
3. Spiritual Adviser/s
70.
71.
73.
Name
74.
October 18, 2015
75.
Pstr. Imelda dela Vega
76.
October 18, 2015
77.
Pstr. Marjoe dela Vega
78.
October 18, 2015
4. Networking
80.
81.
82.
83.
Date of Counseling
Pstr. Manolito dela Vega
79.
4.1
4.2
4.3
4.4
72.
The Great Christian Mission

Local Government Unit of Dumalneg
Barangay Council
Purok Council
84.
85.
86.
87.
Submitted by:
88.
89.
90.
91.
92.
Candidate
93.
Noted by:
94.
95.
96.
97.
99.
100.
101.

Troop Leader
98.
MARINA M. REYNON
Council Executive
102.
LAILA F. MORALES
103.
105.
October 24, 2015

104.
106.
107.
108.
109.
110.
111.
112.
113.
114.
115.
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118.
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120.
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131.
132.
133.
134.
135.
136.
137.
139.
138.
140.
143.
144.
141.
MANILA
142.
CGSMS Form No. 4

145.

146.
147.
PHASE 3 IMPLEMENTATION REPORT due EO JUNE
148.
149.
150.
Name
151.
152.
Council
Troop No.

: Northern Luzon
:
Troop Leader : Jolly Mar T. Mangilaya___________
153.
1. MONTHLY REPORTS
154.
155.
Work Done
156.
Dates
157.
Activities Undertaken
158.
159.
160.
161.
162.
163.
164.
165.
166.
167.
168.
169.
170.
171.
172.
173.
174.
175.
176.
177.
178.
179.
180.
181.
182.
183.
184.
185.
186.
187.
188.
189.
190.
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193.
194.
195.
196.
197.
198.
199.
200.
201.
202.
203.
204.
205.
206.
207.
208.
209.
210.
211.
212.
213.
214.
215.
216.
217.
218.
219.
220.
221.
222.
223.
224.
225.
226.
227.
228.
229.
230.
231.
232.
233.
234.
235.
236.
237.
238.
239.
240.
241.
242.
243.
244.
245.
246.
247.
248.
249.
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251.
252.
253.
254.
255.
256.
257.
258.
259.
260.
261.
262.
263.
264.
265.
266.
267.
268.
269.
270.
271.
272.
273.
274.
275.
276.
277.
278.
279.
280.
281.
282.
283.
284.
285.
286.
287.
288.
289.
290.
291.
292.
293.
294.
295.
296.
297.
298.
299.
2. MEETINGS
300.
Persons Involved
301.
304.
Meetings With
Purok Leader
302.
Dates of Meeting
303.
305.
306.
307.
308.
309.
310.
Work Group with Troop Leader

311.
312.
314.
315.
317.
318.
320.
321.
323.
324.
326.
327.
313.
316.
Monitoring Panel
319.
322.
Others
325.
Results
328.
329.
330.
331.
3. DATE OF VISITS OF THE MONITORING PANEL

4. OBSERVATIONS OF THE MONITORING PANEL
332.
333.
334.
Submitted by:
335.
336.
337.
338.
339.
Candidate
340.
Noted by:
341.
342.
343.
344.
346.
347.
348.

Troop Leader
345.
MARINA M. REYNON
Council Executive
349.
LAILA F. MORALES
350.

351.
352.
353.
354.
355.
356.
357.
358.
359.
360.
361.
362.
363.
364.
365.
366.
367.
368.
369.
370.
371.
372.
June 25, 2015
373.
374.
375.
376.
377.
378.
379.
380.
381.
382.
383.
384.
385.
386.
387.
388.
389.
390.
391.
392.
393.
394.
395.
396.
397.
398.
399.
400.
401.
405.
406.
402.

403.
MANILA
404.
CGSMS Form No. 5

407.

408.
ACCOMPLISHMENT REPORT due EO JUNE

411.
412.
413.
414.
Name
Council
Troop No.
409.
410.

: Northern Luzon
:
415.
1. Summary of the Project
1.1 Narrative Report of Accomplishment

1.2 Effects on the
1.2.1
Community
1.2.2
Candidate
2. Turnover Ceremony
416.
417.
Place
Date
:
:
3. List of Persons Recognized/Appreciated

4. Plans for Sustaining the Project
418.
419.
420.
Assistance Received
421.
422.
423.
424.
425.
426.
427.
428.
429.
430.
431.
432.
433.
434.
435.
436.
437.
438.
439.
440.
441.
442.
443.
444.
445.
446.
447.
Submitted by:
448.
449.
450.
451.
452.

Candidate
Noted by:
453.
455.
456.
457.
June 25, 2015

454.

Troop Leader
458.
MARINA M. REYNON
459.
460.
461.
463.
Council Executive
462.
LAILA F. MORALES
464.

465.
468.
469.
466.
MANILA
467.
CGSMS Form No. 6

470.
CHIEF GIRL SCOUT
471. MEDAL SCHEME
EVALUATION
FORM
472.
473.
474.
475.
476.
Name
477.
478.
479.
480.
Council
Troop No.
Area of Work

: Northern Luzon
:
: HEALTH________________________ Period Covered : July 2015 June 2016___________
481.
I.
483.
a)
b)
c)
d)
e)
f)
g)
CRITERIA FOR EVALUATION
Personal Attributes (30%)
482.
Adequate progress and growth in:

Spiritual and Physical Health
Integrity
Sense of Responsibility
Perseverance, Effort Determination
Manners and Decorum
Knowledge and Skills
Poise and Grooming
RATING
484.
485.
486.
487.
488.
Name and Signature of Troop Leader
II.
489.
Performance (40%)
a) Leadership Abilities
490.
-planning
491.
-organizing
b) Implementation
492.
-follow through of plans
493.
-networking
494.
-use of resources
c) Documentation
495.
-completeness of records (neatness, organization and presentation of
thoughts, presence of required documents
496.
III.
497.
The Project (30%)
a) Community Involvement
b) Effect on:
498.
-the community
499.
-the candidate
c) Sustainability
500.
504.
501.
502.
505.
506.
507.
508.
509.
510.
511.
512.
513.
514.
516.
517.
518.
519.
520.
521.
522.
523.
503.
TOTAL
Note: A percentage of 80-100% qualifies the candidates project to be submitted to GSP-NHQ.
Evaluated by:
________________________________
________________________________
Noted:
515.
LAILA F. MORALES
524.
525.
529.
530.

526.
527.
MANILA
528.
CGSMS Form No. 7

531.
CHIEF GIRL SCOUT
532. MEDAL SCHEME
SUMMARY 533.
OF EVALUATION
534.
535.
536.
537.
Name
538.
539.
540.
541.
Council
Troop No.
Area of Work

: Northern Luzon
:
: HEALTH________________________
543.
542.
NAME OF
546.
545.
POSITION
548.
547.
SIGNATURE
550.
549.
RATING
EVALUATOR
544.
1.
552.
553.
554.
555.
556.
557.
2.
558.
559.
560.
561.
562.
563.
564.
565.
3. VICTORIA M. LADIA
567.
568.
569.
570.
4. MARINA M. REYNON
571.
573.
574.
579.
580.
551.
Commissioner on
Program
566.
Council Executive
572.
576.
575.
577.
Regional
Representative
578.
5.
582.
581.
AVERAGE
584.
583.
585.
586.
587.
588.
589.
590.
591.
592.
593.
595.
596.
Prepared by:
________________________________
________________________________
Noted:
594.
LAILA F. MORALES

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Girl Scouts of the Philippines

NORTHERN LUZON REGION

ILOCOS NORTE-LAOAG COUNCIL

CHIEF GIRL SCOUT MEDAL SCHEME

Family Name: ESPIRITU

School: DUMALNEG NATIONAL HIGH SCHOOL

Troop Leader: JOLLY MAR T. MANGILAYA

Date of Project Started

Summary of Project to show the different stages of the project implementation:

JOLLY MAR T. MANGILAYA

Girl Scouts of the Philippines

ILOCOS NORTE-LAOAG COUNCIL

CHIEF GIRL SCOUT MEDAL SCHEME

MAUREEN JOY C. ESPIRITU

CONSTRUCTION OF VEGETABLE GARDEN AT SITIO LAGUERTA, SAN ISIDRO,

DUMALNEG, ILOCOS NORTE

MISS JOLLY MAR T. MANGILAYA

GIRL SCOUTS OF THE PHILIPPINES

(2 badges for each of the 8 Point Challenge)

Challenge of Economic Self-Sufficiency

Challenge of Economic Self-Sufficiency

3. Eco Good Turns

Challenge of the Environment

Challenge of the Environment

Challenge of Heritage and Citizenship

Challenge of Heritage and Citizenship

Challenge of the Arts

10. Performing Arts

Challenge of the Arts

Challenge of Spirituality and Well-Being

12. A Look at Myself

Challenge of Spirituality and Well-Being

13. Me and My Family

Challenge of Family Life

14. Family Links

Challenge of Family Life

15. Harmony in Diversity

Challenge of World Community

Challenge of World Community

Customs and Traditions

III. CAMPING RECORD

November 06-08, 2014

November 14-16, 2014

D&D by the Sea

December 04-07, 2014

IV. CHIEF GIRL SCOUT SCHEME ORIENTATION/WORKSHOP

Eco Good Turns

4. About the Project

Take a council orientation on the scheme.

Identify the government agencies or NGOs to network with.

Take up a skill which could be of help in the chosen project.

Conduct weekly clean-up drives.

Plant prepared seeds and cuttings.

Sustain the cleanliness of the area.

References (Attach list of titles/topics related to the Project (at least 3)

MAUREEN JOY C. ESPIRITU

September 26, 2015

JOLLY MAR T. MANGILAYA

Regional Executive Director

: MAUREEN JOY C. ESPIRITU____________________________________________________

1. Self-Developmental Skills Acquired and Practiced

1.1 Plant Propagation

2.1 Luke 6:31