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GIRL SCOUTS OF THE PHILIPPINES National Headquarters

Manila

CGSMS Form No. 1

Name : Tricia Grace C. Javier____ Address : #168 Burgos B, Pilar, Bataan Troop No. : 17Region : III Council : BataanTroop Leader : Sharon A. NelmedaRegistration Dates : July 25, 2013 Three (3) Years of Girl Scouting Experience:

20 th JR/SR Encampment November 11-15, 2011_______ 21 st JR/SR Encampment November 8-10, 2012________

Badge workBadge Earned Challenges Dates Earned

1. SINDI-Film Making Activity Arts May 28, 2012______2. Acting Workshop Arts May 20, 2012______ 3. Family Day Family Life October 17, 2013___ 4. Child Care Symposium Family Life August 15, 2013____ 5. STEP Livelihood Eco-Self-Sufficiency August 9, 2013_____6. Retailing/Selling Eco-Self-Sufficiency September 23, 2013_7. Classroom V-Pres. Well-Being June 19, 2013______ 8 .Bible Study Leader Well-Being September 13, 2013_ 9. Earthquake Drill Preparedness August 13, 2013___10. Fire Prevention Preparedness September 27, 2013_11. GSP Week World Community October 24, 2013___12. GSP Seminar World Community November 14, 2013_13. Linggo ng Wika Heritage and Citizenship August 23, 2013___14. Cultural Presentation_ Heritage and Citizenship February 21, 2013__ 15. Tree Planting Environment July 19, 2013______16. Pawikan Festival Environment July 24, 2013______

Camping RecordEncampment Date Place

Troop : __________________________________________________________________________________Council : 21 st JR/SR Encampment November 8-10, 2012 Stella Mariz Beach, Bagac, Bataan Regional : Patrol Leader Campers Permit November 14-16, 2013 Bamban, Tarlac_______________ National : International :

Chief Girl Scout Medal Orientation/ WorkDate : ___July 25, 2013 Place : Bataan Council

Noted by:Sharon A. Nelmeda

Troop LeaderAttachment:1. Troop Leaders’ Endorsements2. Parents’ Endorsements3. Community Survey

Divina V. Agustin Council Executive

Mrs. Angelita A. ManaliliRegional Executive Director

CHIEF GIRL SCOUT MEDAL SCHEME APPLICATION FORM

GIRL SCOUT OF THE PHILIPPINESNational Headquarters

Manila

CGSMS Form No.2

CHIEF GIRL SCOUT MEDAL SCHEMEPHASE 1 REPORT due to EO September

Name : Tricia Grace C. JavierAddress : # 168 Burgos B, Pilar, BataanCouncil : BataanTroop Leader: Sharon A. NelmedaTarget Community:

1. From the community problems/needs surveyed, select only most pressing as recommended by the community for your project.

Feeding Program2. Area of Work (only one): Health3. Badge work

Related Badges Earned Date Earned1._____________________ Arts _______________________________ _ __ May 28, 2012__________ 2. _____________________Arts______________________________________________ May 20, 2012__________3. ____ Family Life___________________________________ _ October 17, 2013________4.___________________Family Life__________________________________________August 15, 2013_________5. ___Eco-Self-Sufficiency ________________________________August 9, 2013_________6. ___Eco-Self-Sufficiency ______________________________September 23, 2013______7. _ Well-Being_____________________________________________June 19, 2013__________8. __________________Well-Being___________________________________________September 13, 2013______9. ________________Preparedness___________________________________________August 13, 2013________10.________________Preparedness___________________________________________September 27, 2013______11. ___ World Community ______________________________October 24, 2013_________12. ____________World Community _________________________________________ November 14, 2013______13.____________Heritage and Citizenship _____________________________August 23, 2013_________14.____________Heritage and Citizenship ______________________________February 21, 2013_______15._________________Environment _____________________________July 19, 2013____________16._________________Environment _____________________________ July 24, 2013 ____________

About the project (use extra sheets)4.1 Project Description: To teach children to be healthy. 4.4 Time Table: see attached file4.2 Objectives: To maintain good health of the children. 4.5 Budget: Php. 4,500.004.3 Methods: Teaching Method

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 Divina V. Agustin 5.3 Mylene C. Larman5.2 Sharon A. Nelmeda 5.4________________

6. Names of Work Group (Prospective CGSMS candidates but not those working already) SKs and other adults.6.1 Rona Mae Buenaflor 6.4 Fatima Romero6.2 Lea Angeles 6.5 Nicole Javier6.3 Hannah Elaine 6.6 Jade Diego

7. References (Attached list of the title/topics to the project (at least 3)Name of Book Topic/Title Read

7.1 The New Living and Learning in Home Economics Good Grooming and Health Habits7.2 Ang pinakamahalagang Kwento sa Lahat Ang Paglikha sa Mundo7.3 Home Economics Dietary Allowance for children

8. From your Readings in No.7 how did you apply the learning’s or insights gained in your project? (use extra sheets)

Noted by: Submitted by: Sharon A. Nelmeda Tricia Grace C. Javier

Troop Leader Candidate

Divina V. Agustin September 2013Council Executive Date

Mrs. Angelita A. Manalili Regional Executive Director

GIRL SCOUTS OF THE PHILIPPINES

National Headquarters

Manila

CGSMS Form No.3

CHIEF GIRL SCOUT MEDAL SCHEME

PHASE 2 REPORT due to EO OCTOBER

Name: Tricia Grace C. Javier Council : Bataan Troop No : 17 Region : IIITroop Leader: Sharon A. Nelmeda

1. Self Development Skills Acquired and Practiced ( At least 3 skills)Self-confidence, learn to be patience and learn to accept people individuality.

2. Spiritual Readings (How did you apply the learning’s gained from your spiritual readings in your projects? At least 5)I put God as the center of my project. We always pray for guidance of our God. The children enlightened during bible study. I learned a lot about the life of God and I tried some of his works. I offer this project to our mighty God.

3. Spiritual Advisers Name/s Dates of counseling

Mylene C. Larman ` November 23, 2013

Sharon A. Nelmeda February 22, 2014

Networking (List the names of Agencies/Organization networked with)

Department of Health Brgy.Health CenterDep’t of Social Worker and Development

Submitted by:

Tricia Grace C. JavierCandidate

Noted by: Sharon A. Nelmeda

Troop Leader

Divina V. Agustin March 13, 2014Council Executive Date

Mrs. Angelita A. ManaliliRegional Executive Director

GIRL SCOUT OF THE PHILIPPINESNational Headquarters

Manila

CGSMS Form No.4CHIEF GIRL SCOUT MEDAL SCHEME

PHASE 3 IMPLEMENTATION REPORT-EO June

Name: Tricia Grace C. Javier Council : Bataan Troop No : 17 Region : IIITroop Leader: Sharon A. Nelmeda

1. Work Done Dates Activities undertaken Person involved(use separate sheets)_______________ __________ _( Please see attached)_________________

Meeting with: Dates of meeting Results ( attach minutes of meetings)

Purok Leader August 24, 2013 (Please see attached) Work Group _August 10, 2013 _______________________________ Monitoring panel

1. Angelita Manalili _______________________________2. Divina Agustin ______________________________3. Anita De Dios ______________________________

Others (specify): ________ _______________________________

Date of visits of monitoring panel3.1 ______________________ 3.2 ____________________________

4. Observations of the monitoring panel (attach copies of observations)

Submitted by:

Tricia Grace C. Javier Candidate

Noted by: Sharon A. Nelmeda

Troop Leader

Divina V. Agustin June 2014Council Executive Date

Mrs. Angelita A. ManaliliRegional Executive Director

GIRL SCOUT OF THE PHILIPPINESNational Headquarters

ManilaCGSMS Form No.5

CHIEF GIRL SCOUT MEDAL SCHEMEACCOMPISHMENT REPORT EO JUNE

Name: Tricia Grace C. Javier Council : Bataan Troop No : 17 Region : IIITroop Leader: Sharon A. Nelmeda 1.Summary of the project

1.1 Narrative Report of Accomplishment ( use extra sheets as needed)1.2 Effects on the:

CommunityParents and the Brgy. Captain were very happy because of the improvements of the children’s health and the success of the project.

CandidateI became more active in clinic organization and I have confidence to face people and trials that God have given to me.

2. Turn-over Ceremony (attach copy of the Program)Place: Brgy. Burgos Multi-Purpose Hall, Burgos B, Pilar, BataanDate: July 11, 2014

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

Marina M. Barlis Book bindingJeany V. Dela Cruz Photocopy and print

4. Plans for the project

I will turn-over the project to one of my workgroups whom I know she will do her best and work hard to achieve her success in this project.

Submitted by: Tricia Grace C. Javier

Candidate

Noted by: Sharon A. Nelmeda

Troop Leader

Divina V. Agustin June 2014Council Executive Date

Mrs. Angelita A. ManaliliRegional Executive Director

GIRL SCOUTS OF THE PHILIPPINES

National Headquarters

Manila

CGSMS Form No.7

CHIEF GIRL SCOUT MADAL SCHEME

SUMMARY OF RATINGS

Name: Tricia Grace C. Javier Council : Bataan Troop No : 17 Region : III Troop Leader: Sharon A. Nelmeda

Area of Work : HEALTH

Name of evaluator Position Signature Rating

1.Council Commissioner

on Program

2. Council Executive

3. Outstanding Citizen

4. Outstanding Citizen

5. Regional Representative

Average

Prepared by:

___________________________________________________

Position

Noted by :

Mrs. Angelita A. ManaliliRegional Executive Director

GIRL SCOUTS OF THE PHILIPPINESNational Headquarters

ManilaCGSMS Form No.6

CHIEF GIRL SCOUT MADAL SCHEME

Evaluation Form

Name: Tricia Grace C. JavierCouncil : BataanTroop Leader: Sharon A. NelmedaArea of Work: HealthPeriod Covered July 2013 - July 2014

CRITERIA FOR EVALUATION

RatingI. Personal Attribute - 30 % ( To be rated by the Troop Leader )Adequate progress and growth in:a. Spiritual and Physical healthb. integritysense of responsibilityd. perseverance, effort, determinatione. manners and decorumf. knowledge and skillsg. poise and groomingname & signature of troop leader

SHARON A. NELMEDAsignature over printed name

II. PERFORMANCE - 40 % ( To be rated by the panel of evaluator)a. leadership abilities :

- Planning- Organizing

b. implementation- Follow through plans- Networking- Use of resources

c. Documentation- completeness of record (neatness, organization and presentation of thoughts, presence of required documents)III. The Project (30 %)

a. Community Involvementb. B. Effect on:

- The community- The candidate

- Sustainability TotalRemarksNote: A percentage of 80-100 % qualifies the candidate’s project to be submitted to GSP-NHQ/

Evaluated by: /Council Commissioner on Program/ Name/Position/Date:

ANGELITA A. MANALILI Regional Executive Director