This document provides details of Hannah Ellaine V. Rivera's application for the Chief Girl Scout Medal. It includes information about her Girl Scouting experience over three years, the badges she has earned, camping records, and the community project she completed for her Chief Girl Scout Medal application. Her project focused on teaching children healthy habits as part of a feeding program. The document outlines the objectives, methods, timetable and budget of the project, as well as her work with consultants, community members, and the positive effects and continued plans for the project.

1. GIRL SCOUTS OF THE PHILIPPINES
National Headquarters
Manila
CGSMSForm No. 1
Name : Hannah Ellaine V. Rivera
Address : #207 del Roasrio, Pilar, Bataan
Telephone No. : 09106631127 Troop No. : 18
Region : III Central Luzon Council : Bataan
Troop Leader : Mary Grace D. Bagtas
Registration Dates : ______________________________________________________________________
Three (3) Years of Girl Scouting Experience:
21st
JR/SR Encampment November 14-18, 2012
22nd
JR/SR Encampment November 15-17, 2013
23rd
JR/SR Encampment November 6-9, 2014
Badge work
Badge Earned Challenges Dates Earned
1. Bataan Day (Tableau Presentation) Arts April9,2014
2. Acting Workshop Arts November 28,2014
3. CYM Family Life June 26,2014
4. Rosary Rally Family Life December 8,2014
5. STEP Livelihood Eco-Self-Sufficiency July 5, 2014
6. Retailing/Selling Eco-Self-Sufficiency September 19, 2014
7. Gift Giving Well-Being December 20, 2013
8. Bible Study Leader Well-Being June 13, 2014
9. Earthquake Drill Preparedness September 13, 2014
10. Fire Prevention Preparedness August 9,2014
11. GSP Week World Community October 24, 2013
12. Seminar (Globl Warming) World Community November 14, 2013
13. Buwan ng Wika Heritage and Citizenship June 27, 2014
14. Flag Disposal Heritage and Citizenship August 20, 2014
15. Tree Planting Environment November 29, 2014
16. KontraKalat Environment September 26, 2014
Camping Record
Encampment Date Place
Troop : Backyard Camping November 28-29,2014 Pablo Roman National High School
Council : 23rd
JR/SR Encampment November 6-9, 2014 Stella Mariz Beach, Bagac, Bataan
Regional : _Regional Encampment December 11-15,2013 Bamban, Tarlac_______________
National :
International :
Chief Girl Scout Medal Orientation/ Work
Date : ___July 25, 2014 Place : Bataan Council
Noted by:
Mary Grace D. Bagtas
Troop Leader
Attachment:
1. Troop Leaders’ Endorsements
2. Parents’ Endorsements
3.Community Survey Divina V. Agustin
Council Executive
Mrs. Angelita A. Manalili
Regional Executive Director
CHIEF GIRL SCOUT MEDAL SCHEME
APPLICATION FORM
2” x 2”
photo

2. GIRL SCOUTOF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No.2
CHIEF GIRL SCOUT MEDAL SCHEME
PHASE 1 REPORT due to EO September
Name: Hannah Ellaine V. Rivera
Address: #207 del Roasrio, Pilar, Bataan
Telephone No: 09106631127
Council: Bataan
TroopLeader: Mary GraceD. Bagtas
Target Community:
1. From the communityproblems/needs surveyed, select onlymost pressingas recommendedby the communityfor your project.
Feeding Program
2. Area of Work(onlyone): Health
3. Badge work
RelatedBadges Earned Date Earned
1. Arts April9,2014________
2. Arts _ November 28,2014_____
3. Family Life_______________ June 26, 2014_________
4._______________Family Life_________________ __________December 8, 2013_______
5. Eco-Self-Sufficiency September 19, 2014______
6. Eco-Self-Sufficiency July 5, 2014_________
7. Well-Being______________ June 13, 2014__________
8. Well-Being______________ December 20, 2013________
9. Preparedness_____________ August 9 , 2014_________
10. Preparedness_____________ September 13, 2014________
11. World Community October 24, 2013_________
12. World Community _ November 14, 2013________
13. Heritage and Citizenship June 27, 2014_____________
14. Heritage and Citizenship ____________August 20, 2014
15. Environment November 29, 2014_________
16. Environment December 8, 2013______
About the project (use extra sheets)
4.1 Project Description: To teach children to be healthy. 4.4 Time Table: Please see attached sheets
4.2 Objectives: To maintain good health of the children. 4.5 Budget: Php. 5,000.00
4.3 Methods: Teaching Method
5. Name of consultant/s beside the TL, (Those who provide technical support toguide in objectives formulation andcongruencyof
activities tothe objectives)
5.1 Mrs. TeresaV. Rivera 5.3 Mrs. Marilyn Macaibay
5.2 Mrs. CharitoV. De Leon 5.4 Mrs. Sharon A. Nelmeda
6. Names of Work Group (Prospective CGSMScandidates but not those workingalready) SKs andotheradults.
6.1 Camille Paguio 6.5 Apple Dela Rosa
6.2 Zhannel Pancho 6.6 Tricia Grace Javier
6.3 Erica Mae artuz 6.7 NicoleJavier
6.4 luckyLain Gatdula 6. LindsayFlores
7. References (Attachedlist of the title/topics tothe project(at least 3)
Name of Book Topic/Title Read
7.1 Technology and Home Economics Balance diet
7.2 Health atHome How to be fit
7.3 Good GroomingBook Good GroomingHabits
8. From your Readings in No.7howdidyouapply the learning’s or insights gainedin your project?(use extra sheets)
Notedby: Submittedby:
Mary Grace D. Bagtas Hannah Ellaine V. Rivera
TroopLeader Candidate
DivinaV. Agustin
Council Executive Date

3. 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: Hannah Ellaine V. Rivera Council : Bataan
Troop No : 18 Region : 3
Troop Leader: Mary Grace D. Bagtas
Self Development Skills Acquired and Practiced ( At least3 skills)
_Health Habits, Prevention, Precaution, Care _
_____________________________________________________________________
1. Spiritual Readings ( How did you apply the learning gained fromyour spiritual readingsin your projects?
At least5)
1.Honesty makes person proud.
2. Helping others is like helping family.
3. Humbleness is the key to heaven.
4. Praying is a good weapon to our problems.
5. Caring is beautiful in the eyes of mighty God.
3. Spiritual Advisers Name/s Dates of counseling
Mylene Larman November 15,2014
Eliza Bagtas ___________ ________ _February 28,2015
Elvis T. Malang __________ May 16,2015
Networking ( List the names of Agencies/Organization networked with)
________________________________
________________________________
Submitted by:
Hannah Ellaine V. Rivera
Candidate
Notedby:
Mary Grace D. Bagtas Date:
Troop Leader
DivinaV.Agustin AngelitaA.Manalili
Council Executive Regional Executive Director

4. GIRL SCOUT OF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No.4
CHIEF GIRL SCOUT MEDAL SCHEME
PHASE 3 IMPLEMENTATION REPORT-EO June
Name: Hannah Ellaine V. Rivera __
Council :Bataan Region: 3 _
Troop No : 18 __ Troop Leader : Mary Grace D. Bagtas
1. Work Done Dates Activities undertaken Person involved
(use separate sheets)
Please see attached sheet (time table)
2. Meeting with:
Dates of meeting Results ( attach minutes of meetings)
 Purok Leader September 12,2014 _______________________________
 Work Group August 10, 2014 _______________________________
 Monitoringpanel 1. _____________ _______________________________
2.______________ _______________________________
3.______________ _______________________________
 Others (specify):________________ _______________________________
3. Date of visits of monitoringpanel
3.1 ______________________ 3.2 ____________________________
4. Observations of the monitoringpanel (attach copies of observations)
Submitted by:
Hannah Ellaine V. Rivera
Candidate
Noted by:
Mary Grace D. Bagtas
Troop Leader __________________________
Divina V. Agustin Date
Council Executive
Angelita A. Manalili
Regional Executive Director

5. GIRL SCOUT OF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No.5
CHIEF GIRL SCOUT MEDAL SCHEME
ACCOMPISHMENT REPORT EO JUNE
Name: Hannah Ellaine V. Rivera___________________________________________
Council : Bataan Region : III _
Troop no: 18 _ Troop leader: Mary Grace D. Bagtas _
1. Summary of the project
1.1 NarrativeReport of Accomplishment ( use extra sheets as needed)
1.2 Effects on the
Community
Parent were very happy because they got or they learned more information about
proper nutrition.
Candidate
I became more active in civic organization and I learned that if we help people we will
be happy. I can now show my confidence in helping people and being a leader.
2. Turnover Ceremony (attach copy of the Program)
Place:__________________________________________________________________
Date: ___________________________________________________________________
3. Listof Persons Recognized/Appreciated AssistanceReceived
(use extra sheets)
GPTA Financial Assistance
FACULTY/ OFFICE Printing _
4. Plans for the project
I will continue to help the children in our barangay and I will help the next Chief Girl
Scout so that she will succeed in her project.
Submitted by:
Hannah Ellaine V. Rivera
Candidate
Noted by:
MARY GRACE D. BAGTAS
Troop Leader
_____________
DIVINA V. AGUSTIN Date
Council Executive
ANGELITA A. MANALILI
Regional Executive Director

6. GIRL SCOUTS OF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No.7
CHIEF GIRL SCOUT MADAL SCHEME
SUMMARY OF RATINGS
Name: Hannah Ellaine V. Rivera_______________________________________________
Council : Bataan Region : 3 _
Troop Leader : Mary Grace D. Bagtas Troop No. 18
Area of Work : Health _
Name of evaluator Position Signature Rating
1.
Council Commissioner
on Program
2.
Executive
3.
Outstanding Citizen
4.
Outstanding Citizen
5.
Regional Representative
Average
Prepared by:
DIVINA V. AGUSTIN
Council Executive
Noted by :
ANGELITA A. MANALILI
Regional Executive Director

7. GIRL SCOUTS OF THE PHILIPPINES
National Headquarters
Manila
CGSMS Form No.6
CHIEF GIRL SCOUT MEDAL SCHEME
Evaluation Form
Name: Hannah Ellaine V. Rivera _ _
Council : Bataan ___
Troop Leader:Mary Grace D. Bagtas _
Area of Work: Health
Period Covered: July 2014 TO July 2015
CRITERIA FOR EVALUATION
Rating
I. PersonalAttribute - 30 % ( To be rated by the Troop Leader )
Adequate progress and growth in:
a. 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
_______________________
MARY GRACE D. BAGTAS
Troop Leader
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 Involvement
b. B. Effect on:
- The community
- The candidate
- Sustainability
total
remarks
Note: A percentage of 80-100 % qualifies the candidate’s project to be submitted to GSP-NHQ/
Evaluated by:
LEONORYCANARE
Council CommissioneronProgram
______________________
Name/Position/Date:
Notedby:
ANGELITA A. MANALILI
Regional Executive Director- OIC