GIRL SCOUTS OF THE PHILIPPINES
NORTHERN LUZON REGION
ILOCOS NORTE – LAOAG COUNCIL
CGSMS Form No. 1
CHIEF GIRL SCOUT MEDAL SCHEME
APPLICATION FORM
I. Personal Information
Name :_________________Samantha D. Mamuad__________________
Address :_____________#20 San Pablo, San Nicolas, Ilocos Norte__
_____ Contact No.
:_____09272804761______ Troop No. 115___
Troop Leader :______________Michelle Joy S. Quemquem_________________
Parents :________Mr. and Mrs. Christoper and Jonalyn Mamuad_______
Occupation :______________Carpenter/Administrative Aide IV_______ ____
Registration Dates : ___2019____ ___2018___ ___2017___
Three (3) Years of Girl Scouting Experience:
________________Escoda Day_______________________
________________World Thinking Day________________
________________Girl Scout Week___________________
II. Badgework (2 badges for each of the 8-Point Challenge)
Badges Earned Challenge
Dates Earned
1. Relating with Others __Challenge of World Community___ _Nov. 17-
19,2017_ 2. _I Love my Body___ Challenge of
Spirituality and Well Being _Nov. 17-19, 2017_ 3. __Outdoor
Cook_ _ ___Challenge of Environment___ _ Nov. 17-19, 2017_
4. __My Family and I_ Challenge of Family Life_____ _Nov. 17-19,
2017_ 5. _I Love Visual Arts__
_______Challenge of the Arts______ _ _Nov. 17-19,2017_
6. _Family Outreach__ _______Challenge of Family Life_____ _Nov. 18-20,
2018_ 7. _Eco Good Turns___ _ Challenge of
Environment______ _Nov. 18-20, 2018_
8. ___Home Nurse___ ____Challenge of Preparedness____ _ _Nov 18-20,
2018_ 9. __I Love to Sing___
_______Challenge of the Arts_______ Nov. 18-20, 2018_
III. Camping Record
Encampment Date Place
Troop : ____Troop Camp_____ __Nov. 9-11, 2018__ _BJC Compound_
District : ___________________ ______________ __
___________ ___
Council : ___Senior Saranay__ _ __Nov. 18-20, 2018_ _DnD ,
Currimao_
Regional : _________________ _ _______________ _ ___________ ___
National : _________________ _ _______________ _ ____________ __
International: _________________ _ _______________ _ ____________ __
IV. Chief Girl Scout Medal Scheme Orientation/Workshop
Date:___07/06/19__ Place: ___IN – Laoag City
Council___
Submitted by: ___Samantha D. Mamuad___
Candidate
Noted by: ___Michelle Joy S. Quemquem__
Troop Leader
____Marina M. Reynon______
Council Executive
_____Laila F. Morales_______
Regional Executive Directo
CGSMS Form No. 1-
A
Community Profile
1.) Name of Purok/Zone: Marunggay St., Sitio 7 Population: 176
2.) Barangay: 20
Municipality/Province/City: San Nicolas, Ilocos Norte
3.) No. Of Families in the Purok: 48 No. Interviewed: 1
4.) No. Of Houses: 41 Light Material: 0 Concrete: 41
5.) No. Of Houses with:
Toilets: 40 Electricity: 40
6.) No. Of Church/Chapel in the Purok/Zone: 1
7.) Means of Transportation Available in the Purok/Zone: Jeep, Tricycle, Van, Motor
8.) No. Of School Children of School Age (6 yrs. – 21 yrs.):
in-school: 42
out-of-school: 3
9.) General Conditions of:
Roads: Cemented Trees and other
plants: Good Garbage Disposal: Collection
rd
every 3 Monday 10.) Person
Interviewed: Mrs. Grace Asuncion
11.) Identified Three (3) Community Problem/Needs
a.) Health Center
b.) Vegetable Garden
c.) Dog
Samantha D. Mamuad
Chief Girl Scout Medal Candidate
7/14/19
Date of Survey
Noted:
Michelle Joy S. Quemquem
Troop Leader
CGSMS Form No. 2
CHIEF GIRL SCOUT MEDAL SCHEME
PHASE 1 REPORT due EO September
Name : Samantha D. Mamuad
Address : #20 San Pablo, San Nicolas, Ilocos Norte
Telephone No. : 09272804761 Troop No.: 115
Council : Ilocos Norte – Laoag Council Region: 1
Troop Leader : Michelle Joy S. Quemquem
Target Community :Marunggay St., Sitio 7
1. From the community problems/needs surveyed, select only one most pressing as
recommended by the community for your project:
The problem within the Sitio is lack of beautification. There are a lot of vacant spaces
wherein they can put up at least a simple garden wherein you can find different kinds of
ornamental plants as well as vegetables but, they seemed to be focused on doing other things. For
example, during weekends, I can see group of youth in a certain area holding their phones and
playing mobile games. Instead of doing nothing during weekends, why don’t we look around and
see what we can do to help our Sitio become cleaner and greener so that it can be a good role
model to other Sitios.
This therefore made me think deeply to conduct a beautification project: to build a
simple garden wherein you can find various kinds of ornamental and flowering plants.
2. Area of Work
ECOLOGY: Beautification of Marunggay St., Sitio 7, San Pablo, San
Nicolas, Ilocos Norte
3. Badgework:
Related Badges Earned Dates Earned
1. Challenge of World Community
Relating with Others Nov. 17-19,2017
2. Challenge of Family Life
My Family and I Nov.
17-19, 2017 Family Outreach Nov.
18-20, 2018 3. Challenge of Environment
Eco Good Turns
Nov. 18-20, 2018 4. About the project
4.1 Project Description:_ Beautification _
4.2 Objectives
This project aims to:
1. To have a healthier lifestyle among the people of the said
Sitio. 2. To assess the teamwork of all people living in
that Sitio. 3. To help our nature maintain its
own beauty.
4.3 Methods
1. Inform the parents about the project.
2. Interview Barangay / Purok officials.
3. Plan for the project & the materials needed.
4. Discuss the project with the Barangay Council.
5. Solicit support from warm hearted persons.
6. Conduct beautification.
7. Monitor progress of the project.
8. Practice everyone to maintain the beautification of the Purok.
4.4 Time Table
July Orientation of the CGSMS
Survey on the Community Profile
August Introduce and discuss the project to the
Barangay Council September Meet the workgroup & discussed
about the project October Solicitation period
Spiritual Counseling
Get ready with
the project November Start to clean
the area Putting
up bamboo
Landscaping
Planting period
December Cleaning the area and watering the plants
Painting the plant boxes
January-March Daily inspection of the project
April Council Visitation
May Cleanliness and Beautification
Monitoring Evaluation and Turnover Ceremony
4.5. Budget
I. Expected Income
II. Estimated Expenses Php 8,995.00
1 kl 2” Nail 100.00
1 kl 3”Nail 100.00
2 kls. Wire 200.00
1 gal. of paint 700.00
20 pcs. Bamboo
1,400.00 30 pcs. of galloon
500.00 5 sachet of eggplant
275.00 5 sachet of kangkong
275.00 5 sachet of
ampalaya 275.00 10
sachet of pechay 550.00
1 bundle of onion 150.00
1 bundle of garlic 200.00
2 sachet of tomato 110.00
2 sachet of okra 110.00
10 pcs. rose 500.00
5 pcs. Bangkok 250.00
Printing of pictures/documentations
1,800.00 Miscellaneous
1,500.00 TOTAL
8,995.00
5. Name of consultants
5.1 Brgy. Captain Marilyn Ulep
5.2 BHW Grace Suncion
5.3 BNS Anabel Balinbin
5.4 Brgy. Kagawad Edwin Manera
6. Name of Work Group
6.1 Maynard Agraan
6.2 Grace Asuncion
6.3 Cherish Bagaoisan
6.4 Chelsie Bagaoisan
7. References
Name of Book
Topic/Title Read 7.1 Natural
Remedies Encyclopedia How to Identify Common Herbs 7.2
Cirisscience.org Environmental Management
7.3 Science Links Causes of Climate Change
8. From your readings in No. 7 how did you apply the learnings or insights gained in your
project?
From my readings, we all know that climate change is very rampant here
in our country nowadays. So, we need to consider the things that causes climate change. I
learned that environmental management is one of the things that we need to consider for our
country to become unpolluted. By putting up a simple garden wherein you can find different
kinds of ornamental and flowering plants, it can be a good start for us, in our sitio, to become
more active in making our sitio clean and green.
Noted by: Submitted by:
_Michelle Joy S. Quemquem_ __Samantha D. Mamuad_
Troop Leader Candidate
_ Marina M. Reynon _
____Sept. 28, 2019_____ Council Executive
Date
____ Laila F. Morales
___ Regional Executive Director
CGSMS Form No. 2
CHIEF GIRL SCOUT MEDAL SCHEME
PHASE 1 REPORT due EO September
Name :_________________Samantha D. Mamuad_______________ __
Address :_____________#20 San Pablo, San Nicolas, Ilocos Norte__ __ ___
Telephone No. :_____09272804761______ Troop No. 115___
Council : __Ilocos Norte – Laoag Council _ Region:____1___ _
Troop Leader :______________Michelle Joy S. Quemquem______________ __
Target Community :__________ ___Marunggay St., Sitio 7_ _______________ _
1. From the community problems/needs surveyed, select only one
most pressing as recommended by the community for your project:
________________________Lack of Vegetable
Garden_____________________ 2. Area of Work
ECOLOGY: Beautification of Marunggay St., Sitio 7, San Pablo,
San Nicolas, Ilocos Norte 3. Badgework:
Related Badges Earned
Dates Earned
4. About the project
4.1 Project Description:_ Beautification _
4.2 Objectives
This project aims to:
1. To have a healthier lifestyle among the people of the said sitio.
2. To assess the teamwork of all people living in that sitio.
3. To help our nature maintain its own beauty.
4.3 Methods
1. Inform the parents about the
project. 2. Interview Barangay / Purok
officials. 3. Plan for the project & the
materials needed. 4. Discuss the project
with the Barangay Council. 5. Solicit support
from warm hearted persons. 6. Conduct
beautification. 7. Monitor
progress of the project. 8.
Practice everyone to maintain the beautification of the Purok.
7. References (Attach list of titles/topics related to the Project- (at least 3)
Name of Book Topic/Title Read
7.1___________________________
_______________________________ 7.2___________________________
_______________________________
7.3___________________________ _______________________________
8. From your readings in No. 7 how did you apply the learnings or insights gained
in your project?
CGSMS Form No. 3
CHIEF GIRL SCOUT MEDAL SCHEME
PHASE 2 REPORT EO December
Name : Samantha D. Mamuad
Council : Ilocos Norte - Laoag Council
Region : 1
Troop No. : 115
Troop Leader : Michelle Joy S. Quemquem
1. Self Development Skills Acquired and Practiced
Time Management
Through this project, I realized that time management is very important because
doing things at the same time is not easy to accomplish, conflicts between household, family
friends and schooling. I have to schedule everything in order to avoid conflicts and it would be
easy for me to undertake because I set time table to follow which will make my work easier.
Money Management
I learned how to budget money for the materials needed in my project especially I
still have important things to buy for school purposes and also for personal. Financial
management is very important in order to come up a good and quality project.
Leadership
Being a Senior Scout, I learned how to become a leader to my workgroup and
other members of the community. Being a leader is also a good model and follower to the youth
in maintaining cleanliness and beautification of our community. In doing my project, I become a
responsible leader in initiating good values and concern to our environment especially in our
Purok. I also helped our community in being healthy by giving them free vegetables and those
who don’t have anything to eat, they are free to get what they want from my garden.
2. Spiritual Readings (How did you apply the learnings gained from your spiritual
readings in your project? - at least 5)
Ephessians 5:16
We must be careful on how we should live as men and women who are wise. We
must use every part of every day to do good things. We need to take care especially about how
we use our time. Use it in the right way. Use every opportunity to turn people from darkness to
light.
Matthew 6:20
Money is valuable to every person. Every day, we need money to buy food,
drinks etc. But money should not last forever. So, use your money to help others because using
your money to help others are the things that last forever.
Mark 9:35
Some leaders today are using their leadership to claim that they are the great of
all. But, the bible is clearly emphasizing that to be great, learn to be a servant. A GREAT
LEADER IS A SERVANT.
3. Spiritual Adviser/s
Name/s Dates of Counseling
1. Pastora Annie Rose Apaga December 12, 2019
2. Pastor Sonny Boy Apaga December 12, 2019
4. Networking (List the name of Agency/Organizations networked with.)
Barangay and Purok Officials
Barangay Health Workers
Sangguniang Kabataan.
Noted: Submitted by:
Michelle Joy S. Quemquem Samantha D. Mamuad
Troop Leader Candidate
Marina M. Reynon December 15, 2019
Council Executive Date
Laila F. Morales
Regional Executive Director
GIRL SCOUTS OF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No. 4
CHIEF GIRL SCOUT MEDAL SCHEME
PHASE 3 IMPLEMEMTATION REPORT – EO June
Name :_________________Samantha D. Mamuad_______________ __
Council :_________________ Region:_________1______
Troop No. :_________115_____ Troop Leader: Michelle Joy S. Quemquem
