Girl Scouts of the Philippines

RIZAL COUNCIL
APPLICATION FORM

EVENT: Montalban Sub-Office GSP Testing Camp

DATE: January 5-7, 2024

PERSONAL INFORMATION

NAME: Ethel Marie C. Burce

DATE of BIRTH: 12-27-93 AGE: 30

TROOP NO.: SCHOOL/DISTRICT: Montalban Heights NHS/ Rizal

AGE LEVEL: 12-15 yrs. Old

LAST REGISTRATION DATE: September 2023

NO. OF YEARS IN SCOUTING: 4 Years

RELIGION: Baptist

FOOD PROHIBITION: None

GSP EVENTS ATTENDED: Basic Training Course 2020 & OLC 2023

IN CASE OF EMERGENCY PLEASE NOTIFY: Mark Anthony M. Burce

ADDRESS: Blk3 Lot7 San Juan St. Jecmat VRV, San Jose Montalban Rizal

TELEPHONE NO: 09507366827

APPLICANT SIGNATURE

CERTIFICATION

I hereby certify that the applicant has met all the requirements for participation in the event.

GERALD F. PINGAN
Head Teacher III
 Girl Scouts of the Philippines

DISTRICT CAMP

CLEARANCE

Sub-Camp Name:

Unit Camp:

Name of School:

Number of Participants:

Number of Troop Leaders:

The following must be inspected by the Sub-Camp Staff:

REMARKS:

 Ground/ Activity Area

 Toilet and Bath Area

 Dismantled Tent

 Properly Garbage Disposal

SIGNATURE

Program Coordinator:

Health Safety and Sanitation Officer:

Business Manager:

Quarter Master:

Camp Director:

Note: Present this form to the officers, serves as your GATE PASS.