Application-Form-1-And-Form-1-A-2 (1) GSP Form
Application-Form-1-And-Form-1-A-2 (1) GSP Form
NATIONAL HEADQUARTERS
Manila
SUBMITTED BY:
__MAYKYLLA P.DIMALALUAN
Candidate
ENDORSED BY:
NIMPHA L. SILVANO
Council Executive
NOTED BY:
RIZALINA D. ALEMANIA
Regional Executive Director
GIRL SCOUT OF THE PHILIPPINES
NATIONAL HEADQUARTERS
Manila
Summary of the Project to show the different stages of the project implementation:
Pre-planning:
SEE ATTACHMENTS
Planning:
SEE ATTACHMENTS
Implementation:
SEE ATTACHMENTS
Turning over of projects to the community leaders:
SEE ATTACHMENTS
Evaluation:
SEE ATTACHMENTS
Preparation of reports:
SEE ATTACHMENTS
Personal experience/s significant contributions to the community and the lessons learned in carrying
out the project:
SEE ATTACHMENTS
SUBMITTED BY:
MAYKYLLA P. DIMALALUAN
Candidate
ENDORSED BY:
NIMPHA L. SILVANO
Council Executive
NOTED BY:
RIZALINA D. ALEMANIA
Regional Executive Director
GIRL SCOUTS OF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No. 1
CHIEF GIRL SCOUT MEDAL SHEME
APPLICATION FORM
Noted by:
Attachments: CHERRY ANN D. DUNGANON
1. Troop Leader’s Endorsements Troop Leader
2. Parent’s Endorsements
3. Community Survey NIMPHA L. SILVANO
Council Executive
Date:
COMMUNITY PROFILE CGSMS FORM No. 1-A
1) Name of Purok/Zone: Purok 3 ______ Population:_________
2) Barangay: Lepaga _ Municipality/Province/City: MLANG, NORTH COTABATO
3) No. of Families in the Purok: ___ _____________No. of Interviewed:
4) No. of Houses
Light materials :
Concrete :
5) No. of houses with
Toilets : _ ___________________ _
Electricity : _
Running water : _______________________ __________
Artesian well : ___________________________ __________
Flower gardens : __________________________ __________
Vegetable gardens : __________________________ _
Poultry : __________________ _____ __________
Piggery : ___________ _____________ _
Others (specify) : ____ ______________________
6) No. of school/s in the purok/zone: __________________________________
7) No. of church/chapel in the purok/zone: ______________________________
8) Government offices located in the purok/zone: ________________________
9) No. of hospital/clinic in the purok/zone: ______________________________
10) Community centers available like day care, reading, health center, others (specify) in the
purok/zone: ____________________
11) Means of transportation available in the purok/zone: _____________________
12) Recreational facilities available in the purok/zone:
13) Means of livelihood/occupation/employment of the people in the purok/zone: _____
14) Educational attainment of the: (Indicate number)
Men (Elementary, High School) __ _____
Women (Elementary, High School) ____
15) No. of school children of age (6 yrs.-21 yrs.)
In school_ _________________________________________________________
Out-of-school__ ____________________________________________________
16) General condition of:
Roads : ____ _____________________
Drainage : _________________________________________
Park/plaza : ___ _________________________________ _
Trees and other plants : ________________________________________
Playground for children : _ ______________________________________
Market : _
Garbage disposal : ______ _________________________________
17) Person/s interviewed: ___________________
18) Identified three (3) Community Problem/Needs:
a) PUROK CENTER AND BEAUTIFICATION
b) DRAINAGE
c) GARBAGE DISPOSAL
Noted: