MESSENGERS OF PEACE

INDIVIDUAL FORM

Instructions :
1. Please complete all detail requirement in this Individual Form.
2. Please submit your individual form to your MoP State Coordinator.
3. Only submit softcopy of your reflection in WORD file through email, to your
MoP State Coordinator.

Format :
1. Your reflection should be typewritten.
2. Using font (Verdana, 9) only.
3. Using 1.5 spacing with Justify text.
 MESSENGERS OF PEACE SCOUT PHOTO

INDIVIDUAL FORM
(To be filled by an individual)

CANDIDATE INFORMATION
Name : scout.org ID :
______________________________________________________________________

Identification Card No. : Phone No. :

______________________________________________________________________

E-mail Address :
______________________________________________________________________

Address :

______________________________________________________________________

SCOUTING INFORMATION
Membership No. : Scout Group :
______________________________________________________________________

District : State :
______________________________________________________________________

Scout Level :
☐ Cub Scout (PKK) ☐ Scout (PM) ☐ Senior Scout (PR)
☐ Rover Scout (PK) ☐ Adult Leader ☐ Others ______________

LEADER INFORMATION
Name : Phone No. :
______________________________________________________________________

Position :
______________________________________________________________________

E-mail Address :
______________________________________________________________________

FOR OFFICE USE ONLY

Date Received : Record No :

MoP State : National HQ :
Coordinator Commissioner
Application : ACCEPTED / REJECTED Duty Officer :
Status

Reasons for : Does not meet service hours requirement

rejection Storytelling on scout.org is unclear / incomplete
………………………………………………………………………………………………………

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MESSENGERS OF PEACE | INDIVIDUAL FORM
Brief Description of the Scout Involvement in Messengers of Peace :
(General description and narrative report. Include accomplishment, lesson learned or plan for the future, if
available. Use extra sheet, if necessary)

a. What have you achieved during participating / conducting peace activities?

b. Learnings/Experience of Scouts
(what are the positive outcomes/changes that took place as a result of your peace actions)

c. Trail/Plan Ahead
(Do you have any plans for Scouts’ engagement program with community after your project finished?)

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MESSENGERS OF PEACE | INDIVIDUAL FORM