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Agas-moro (Vernonia cinerea Linn.) Anti-CF (Cold and Fever) Ointment

Yveth V. Gameng, Jenylyn V. Cortado, Giselle Anne G. Valdez
Animal Sciences
Candon National High School, Candon City, Philippines

This study entitled "Agas-moro (Vernonia cinerea Linn.) Anti-CF (Cold and Fever) Ointment" aims
to give treatment to the most catched diseases nowadays, the cold, cough, and fever. This study can
help some mothers because instead of buying expensive medicine or treatment for their children having
the CCF, they can just look for agas-moro around their surroundings.
This study entitled "Agas-moro (Vernonia cinerea Linn.) Anti-CF (Cold and Fever) Ointment"
was investigated to prove the hypotheses that aga-moro can be utilized and effective reliever
ointment.
Specifically, these hypotheses were formulated.
1. Agas-moro is an effective ointment for cold and fever.
2. There is no significant difference between the agas-moro
(Vernonia cinerea Linn.) ointment and the commercialized
ointment (VAPOCOOL).
The researchers gathered and washed fifty grams (50 g) of agas-moro and soaked to one
hundred milliliters (100 ml) of ethyl alcohol for twenty four hours (24 hrs). After soaking, the researchers
melted the one hundred twenty five grams (125g) of beeswax and mixed with the extract of agas-moro.
The researchers mixed also the extracted ten grams (10g) of eucalyptus leaves and transferred to a
clean container.
Based on the findings, the agas-moro can be utilized as an ointment to relieve colds and fever
Further study is recommended to improve the expiration and packaging of the product.
Behavioral and
Social Science
Biochemistry
Cellular &
Molecular Biology
Chemistry
Computer Science
Earth Science
Eng: Electrical &
Mechanical
Eng: Materials &
Bioengineering
Energy &
Transportation
Environmental
Management
Environmental
Sciences
Mathematical
Sciences
Medicine and
Health
Microbiology
Plant Sciences
1
2
As a part of this research project, the student directly handled, manipulated, or

interacted with (check ALL that apply):
human subjects
potentially hazardous biological agents
vertebrate animals
Microorganisms
rDNA
2. This abstract describes only procedures performed by

me/us, reflects my/our own independent research, and
represents one years work only
3. I/we worked or used equipment in a regulated
research institution or industrial setting:
4. This project is a continuation of previous research.
Yes
5. My display board includes non-published photographs/visual

depictions of humans (other than myself):
Yes
6. I/we hereby certify that the abstract and responses to the

above statements are correct and properly reflect my/our own
work.
Yes
tissue
Physics and
Astronomy
Page | 2
Yes
No
Yes
No
No
No
No
This stamp or embossed seal attests that this project is in compliance with all federal and state laws and
regulations and that all appropriate reviews and approvals have been obtained including the final clearance by
the Scientific Review Commit
TABLE OF CONTENTS
TITLE PAGE..1
ABSTRACT.2
TABLE OF COBTENTS....3
ACKNOWLEDGEMENT.4
CHAPTER I..5
RESEARCH PLAN...5
A. Question or Problem ..5
B. Goals/Unexpected Outcomes/Hypotheses.5
C. Methods and Procedure.5-6
D. Bibliography6
CHAPTER II..7
RESEARCH DATA BOOK..7
CHAPTER III.8
RESEARCH PAPER.8
A. TITLE PAGE .8
B. INTRODUCTION..8
a. Background of the Study.8
b. Statement of the Problem....8
c. Formulation of Hypotheses10
d. Significance of the Study10
e. Scope and Limitation..11
f. Theoretical Framework..11
g. Conceptual Framework..12
C. METHODS AND MATERIALS..13
D. RESULTS AND DISCUSSION13-14
E. CONCLUSIONS AND RECOMMENDATIONS...15
F. BIBLIOGRAPHY.15
FORMS...16-36
ACKNOWLEDGEMENT
In appreciation to the full support in the completion of this investigatory project entitled: Tamarind (Tamarindus
indica) Seeds Coffee. The researchers hereby acknowledged the personnel for their unselfish guidance and
direction;
To Mr. Danilo Basabas, the Supervisor of the Science Department for giving words of wisdoms and
sharing knowledge about the project; to Mrs. Pacita L. Basabas, the school Principal for permitting the
researchers to use the facilities of the school in connection to the study and had given sincere inspiration towards
the work; to Ms. Cecilia Galinta, the Head Teacher of the Science Department for checking and who suggested
some important parts of this study; to Ms. Ann Marie J. Baltazar for guising us in writing the write up and the
whole written work and to the researchers families and friends for lending some materials, for shouldering the
financial aspects and sharing ideas about the project.
Above all, the researchers expressed their thanks to God Almighty for giving the courage to complete this
investigatory project.
The researchers,
Charity Ribucan
CHAPTER II
PROJECT DATA BOOK
Activities
Planning the investigatory project
Setting the Experiment
Listing of materials needed
Writing the rough draft procedure
Experimentation
Finalizing the experiment
Gathering of Result
Data Presentation
Data analysis
Finalizing the project
Week
4
The researchers started planning their investigatory project which entitled, Tamarind (Tamarindus Indica) on the
Republic of the Philippines
Region I
Candon City Division
CANDON NATIONAL HIGH SCHOOL
Tamarind
(Tamarindus
Indica)
RESEARCHERS
Yveth V. Gameng
Jenylyn V. Cortado
Giselle Anne G. Valdez
IV- Michael Faraday
Candon National High School
CHAPTER III
RESEARCH PAPER
INTRODUCTION
A. BACKGROUND OF THE STUDY
B. STATEMENT OF THE PROBLEM

This investigatory project entitled "Tamarind (Tamarindus Indica)" aimed to produce an
effective yet affordable coffee. Specifically, it sought to answer the following questions:
1. How effective the Tamarind (Tamarindus Indica) is?
2. Is there a significant difference between Tamarind (Tamarindus Indica) as compared to the commercial
one?
C. FORMULATION OF HYPOTHESES
To arrive with the answer of this research, the following hypotheses are formulated:
1. Tamarind (Tamarindus Indica) is an effective coffee.
2. There is a significant difference between the tamarind (Tamarindus Indica) as compare to the
commercialized one (nescafe)
D. SIGNIFICANCE OF THE STUDY

The use of the eco-friendly tamarind is considered alternative due to its effectiveness, low cost and
availability of resources. The results of the study are of great help to the following:
STUDENTS, CITIZENS, AND OTHER PEOPLE IN THE COUNTRY
They can now use a cheaper coffee and dont have to spend too much money for those expensive
beverages.
ENVIRONMENTALISTS
Since, the Tamarind (Tamarindus Indica) is made from organic matter, it is more eco-friendly
compared to the commercialized coffee which are made of (mostly combinations of pure elements). Thus,
it helps a lot in promoting the advocacies of such environmental groups.
RESEARCHERS
Those who will conduct the same study, or related study on this, they may use the findings as their
bases for a better research.
E. SCOPE AND LIMITATIONS

This study was focused on the determination of the effectiveness of Tamarind (Tamarindus Indica) as
coffee as compared to commercial coffee found in the market. This was conducted at the researchers
addresses at Balingaoan, Candon City, Ilocos Sur and it is also conducted at Candon National High
School, Bagani Campo, Candon City, Ilocos Sur.
This study has the following limitations: First, the study was tried only by the researchers and their
families. Second, the study was tried for two trials and any observation for the effectiveness.
F. THEORETICAL FRAMEWORK
GATHERING MATERIALS
PREPAIRING MATERIALS
EXTRACTING
HEATING
MIXING
COOLING
G. CONCEPTUAL FRAMEWORK
The
were gathered
The were washed and

prepared
The
The
The
The
MATERIALS AND METHODS

The researchers used the following materials in the production of the product.
On the production of the product, the researchers gathered and washed
RESULTS & DISCUSSION

After executing all the procedures to produce an effective coffee from the seeds of Tamarind
(Tamarindus Indica) and after testing the product, the researcher came up with the results showed below.
Table 1.
This was sufficient for executing the experiment in the variables, testing and observing as well.
Table 2. Effectiveness of the Tamarind

Trials
Effectiveness
Accepted
Accepted
LEGEND:
Highly Accepted- its effectiveness is very good.
Effective its effectiveness good enough
Not Effective its not good
The table shows that Tamarind (Tamarindus indica) is an effective coffee. It also shows in the table that
Tamarind (Tamarindus Indica) is accepted in terms of the effectiveness of it.
Table 3. The number of trial and corresponding results.
No. of trials
Days
Coffee
Results
Tamarind Coffee
Commercial Coffee
Tamarind Coffee is
effective
Tamarind Coffee
Commercial Coffee
Tamarind Coffee is
effective
Table 3 presented the results of the study. It showed the number of trials with the corresponding days and
the results of the study. Results showed that after 1 day of using it, this was effective, similar with the commercial
one. This means that Tamarind is effective.
CONCLUSION AND RECOMMENDATIONS
Results of the study showed that the Tamarind (Tamarindus Indica) can be a source of making
coffee and it is effective. This could not only make us save but also can lessen pollution in the
environment. There is a significant difference between the Tamarind (Tamarindus Indica) and the
commercial ones.
For further study, the researchers recommend to improve the quality of the Tamarind (Tamarindus
Indica), especially on its odor and appearance. The researchers recommend using this product in
order for us to lessen the waste in our environment.
BIBLIOGRAPHY
Checklist for Adult Sponsor (1)

This completed form is required for ALL projects.
To be completed by the Adult Sponsor in collaboration with the student researcher(s):
Students Name(s):
Project Title: Tamarind( Tamarindus Indica) Seeds Coffee
1) I have reviewed the Intel ISEF Rules and Guidelines.
2) I have reviewed the students completed Student Checklist (1A) and Research Plan.
3) I have worked with the student and we have discussed the possible risks involved in the project.
4) The project involves one or more of the following and requires prior approval by an SRC, IRB, IACUC or IBC:
Humans
Potentially Hazardous Biological Agents
Vertebrate Animals
MicroorganismsrDNATissues
5) Items to be completed for ALL PROJECTS
Adult Sponsor Checklist (1)
Research Plan
Student Checklist (1A)
Approval Form (1B)
o Regulated Research Institutional/Industrial Setting Form (1C) (when applicable after completed experiment)
o Continuation/Research Progression Form (7) (when applicable)

6) Additional forms required if the project includes the use of one or more of the following (check all that
apply):
Humans(Requires prior approval by an Institutional Review Board (IRB); see full text of the rules.)
o Human Participants Form (4) or appropriate Institutional IRB documentation
o Sample of Informed Consent Form (when applicable and/or required by the IRB)
o Qualified Scientist Form (2) (when applicable and/or required by the IRB)
Vertebrate Animals(Requires prior approval, see full text of the rules.)
o Vertebrate Animal Form (5A)for projects conducted in a school/home/field research site (SRC prior
approval required.)
o Vertebrate Animal Form (5B)for projects conducted at a Regulated Research Institution. (Institutional
Animal Care and Use Committee (IACUC) approval required prior experimentation.)
o Qualified Scientist Form (2) (Required for all vertebrate animal projects at a regulated research site or when
applicable)
o Potentially Hazardous Biological Agents (Requires prior approval by SRC, IACUC or Institutional Biosafety
Committee (IBC), see full text of the rules.)
Potentially Hazardous Biological Agents Risk Assessment Form (6A)
Human and Vertebrate Animal Tissue Form (6B)to be completed in addition to Form 6A when project involves
the use of fresh or frozen tissue, primary cell cultures, blood, blood products and body fluids.
Qualified Scientist Form (2) (when applicable)

Risk Assessment Form (3) required for projects involving protists, archae and similar microorganisms,
forprojects using manure for composting, fuel production or other non-culturing experiments, for projects
using color change coliform water test kits, microbial fuel cells, and for projects involving decomposing
vertebrate organisms
o Hazardous Chemicals, Activities and Devices (No prior approval required, see full text of the rules.)
Risk Assessment Form (3)
Qualified Scientist Form (2) (required for projects involving DEA-controlled substances or
whenapplicable)
ANN MARIE J. BALTAZAR
Adult Sponsors Printed Name
Signature
Phone: ___________
Date of Review
Email: annmarie_baltazar@yahoo.com
Student Checklist (1A)

This form is required for ALL projects
1) a. Student/Team Leader:
Grade:
Email:
Phone:
b. Team Member:
c. Team Member:
Tamarind (Tamarindus
2) Title of Project: Indica) Seeds Coffee
3) School: CNHS
School Phone: 742-6456
School Address: Bagani Campo, Candon City
Ilocos Sur
4) Adult Sponsor:
Ann Marie J. Baltazar
Phone/Email: annmarie_baltazar@yahoo.com
5) Is this a continuation/progression from a previous year? Yes No

If Yes:
Research Plan
a) Attach the previous years Abstract and
b) Explain how this project is new and
Continuation/Research Progression Form (7)
different
from
previous
years
6) This years laboratory experiment/data collection: (must be stated (mm/dd/yy))
Start Date: (mm/dd/yy)
End Date: (mm/dd/yy)
7) Where will you conduct your experimentation? (check all that apply)
Research Institution School
Field
Home
Other:
________________________
on
8) List name and address of all non-school work site(s):

Name:
Address:
Phone:
9) Complete a Research Plan following the Research Plan instructions and attach to this form.
10) An abstract is required for all projects after experimentation.
Research Plan Instructions

A complete research plan is required and must accompany Checklist for Student (1A)
Provide a typed research plan and attach to Student Checklist (1A). Please include your name on each page.
The research plan for ALL projects is to include the following:
A. Question or Problem being addressed
B. Goals/Expected Outcomes/Hypotheses
C. Description in detail of method or procedures (The following are important and key items that should be included
when formulating ANY AND ALL research plans.)
Procedures: Detail all procedures and experimental design to be used for data collection
Risk and Safety: Identify any potential risks and safety precautions to be taken.
Data Analysis: Describe the procedures you will use to analyze the data/results that answer research questions or
hypotheses
D. Bibliography: List at least five (5) major references (e.g. science journal articles, books, internet sites) from your
literature review. If you plan to use vertebrate animals, one of these references must be an animal care reference. o
Choose one style and use it consistently to reference the literature used in the research plan
o Guidelines can be found in the Student Handbook
Items 14 below are subject-specific guidelines for additional items to be included in your research plan as applicable:
1. Human participants research:
Participants. Describe who will participate in your study (age range, gender, racial/ethnic composition). Identify any
vulnerable populations (minors, pregnant women, prisoners, mentally disabled or economically disadvantaged).
Recruitment. Where will you find your participants? How will they be invited to participate?
Methods. What will participants be asked to do? Will you use any surveys, questionnaires or tests? What is the
frequency and length of time involved for each subject?
Risk Assessment
o Risks. What are the risks or potential discomforts (physical, psychological, time involved, social, legal, etc.) to
participants? How will you minimize the risks?
o Benefits. List any benefits to society or each participant.
Protection of Privacy. Will any identifiable information (e.g., names, telephone numbers, birth dates, email addresses)
be collected? Will data be confidential or anonymous? If anonymous, describe how the data will be collected
anonymously. If not anonymous, what procedures are in place for safeguarding confidentiality? Where will the data
be stored? Who will have access to the data? What will you do with the data at the end of the study?
Informed Consent Process. Describe how you will inform participants about the purpose of the study, what they will
be asked to do, that their participation is voluntary and they have the right to stop at any time.
2. Vertebrate animal research:
Briefly discuss potential ALTERNATIVES to vertebrate animal use and present a detailed justification for use of
vertebrate animals
Explain potential impact or contribution this research may have
Detail all procedures to be used

o Include methods used to minimize potential discomfort, distress, pain and injury to the animals during the
course of experimentation
o Detailed chemical concentrations and drug dosages
Detail animal numbers, species, strain, sex, age, source, etc.

o Include justification of the numbers planned for the research
Describe housing and oversight of daily care
Discuss disposition of the animals at the termination of the study

3. Potentially Hazardous Biological Agents:
Describe Biosafety Level Assessment process and resultant BSL determination
Give source of agent, source of specific cell line, etc.
Detail safety precautions
Discuss methods of disposal

4. Hazardous Chemicals, Activities & Devices:
Describe Risk Assessment process and results
Detail chemical concentrations and drug dosages
Describe safety precautions and procedures to minimize risk
Discuss methods of disposal
Approval Form (1B)

A completed form is required for each student, including all team members.
1) To Be Completed by Student and Parent

a) Student Acknowledgment:
I understand the risks and possible dangers to me of the proposed research plan.
I have read the Intel ISEF Rules and Guidelines and will adhere to all International Rules
when conducting this research.
I have read and will abide by the following Ethics statement
Scientific fraud and misconduct are not condoned at any level of research or competition. Such practices include
plagiarism, forgery, use or presentation of other researchers work as ones own, and fabrication of data.
Fraudulent projects will fail to qualify for competition in affiliated fairs and the Intel ISEF.
Students Printed Name
Signature
Date Acknowledged (mm/dd/yy)

(Must be prior to experimentation.)
b) Parent/Guardian Approval: I have read and understand the risks and possible dangers involved in the
Research Plan. I consent to my child participating in this research.
Parent/Guardians Printed Name
Signature

2) To be completed by the local or affiliated Fair SRC

(Required for projects requiring prior SRC/IRB APPROVAL. Sign 2a or 2b as appropriate.)
a) Required for projects that need prior SRC/IRB
approval BEFORE experimentation
(humans, vertebrates or potentially hazardous
biological agents)
b) Required for research conducted at all Regulated

Research Institutions with no prior fair SRC/IRB
OR
approval.
This project was conducted at a regulated research
institution (not home or high school, etc.), was
The SRC/IRB has carefully studied this projects Research
reviewed and approved by the proper institutional
Plan and all the required forms are included. My signature
board before experimentation and complies with the
indicates approval of the Research Plan before the
Intel ISEF Rules. Attach (1C) and required institutional
student begins experimentation.
approvals (e.g. IACUC, IRB).
SRC Chairs Printed Name
SRC/IRB Chairs Printed Name

Signature
Date of Approval (mm/dd/yy)

3) Final Intel ISEF Affiliated Fair SRC Approval
Signature
(Required for ALL Projects)
SRC Approval After Experimentation and Before Competition at Regional/State/National Fair

I certify that this project adheres to the approved Research Plan and complies with all Intel ISEF Rules.
Regional SRC Chairs Printed Name
Signature
Date of Approval
State/National SRC Chairs Printed Name
Signature
Date of Approval
(where applicable)
Approval Form (1B)

Signature

c) Parent/Guardian Approval: I have read and understand the risks and possible dangers involved in the
Signature


biological agents)

OR
approval.

Signature

Signature

Signature
Date of Approval
Signature
Date of Approval
(where applicable)
Approval Form (1B)


Signature

d) Parent/Guardian Approval: I have read and understand the risks and possible dangers involved in the
Signature


biological agents)

OR
approval.

Signature
Signature

Signature
Date of Approval
Signature
Date of Approval
(where applicable)
Regulated Research Institutional/Industrial Setting Form (1C)

This form must be completed AFTER experimentation by the adult supervising the student research conducted
in a regulated research institution, industrial setting or any work site other than home, school or field.
This form MUST be displayed with your project; responses must be on the form.
Students Name(s)
Title of Project
Tamarind (Tamarindus Indica) Seeds Coffee
To be completed by the Supervising Adult in the Setting (NOT the Student(s)) after experimentation:
(Responses must remain on the form as it is required to be displayed at students project booth.)
The student(s) conducted research at my work site:
a) to use the equipment
b) to perform experiment(s)/conduct research
1) Is this research a subset of your work?
Yes No
2) Have you reviewed the Intel ISEF rules relevant to this project?
Yes No
3) How did the student get the idea for her/his project?
(e.g. Was the project assigned, picked from a list, an original student idea, etc.)
4) Did the student(s) work on the project as a part of a research group?
YesNo
If yes, how large was the group and what kind of research group was it (students, group of adult researchers, etc.)
5) What specific procedures or equipment did the student(s) actually use for the project?
Please list and describe. (Do not list procedures student only observed.)
6) How independent or creative was the students/students work?
Student research projects dealing with human participants, vertebrate animals or potentially hazardous
biological agents require review and approval by an institutional regulatory board (IRB/IACUC/IBC). Copy of
approval(s) must be attached, if applicable.

Supervising Adults Printed Name
Signature
Title

Institution
San Esteban
Address
Date Signed (must be after experimentation)
annmarie_baltazar@yahoocom
Email/Phone
Risk Assessment Form (3)

Required for projects using hazardous chemicals, activities or devices and microorganisms
exempt from pre-approval. Must be completed before experimentation.
Students Name(s)
Title of Project: Tamarind (Tamarindus Indica) Seeds Coffee
To be completed by the Student Researcher(s) in collaboration with Designated Supervisor/Qualified
Scientist: (All questions must be answered; additional page(s) may be attached.)
1. List/identify microorganisms exempt from pre-approval (see Potentially Hazardous Biological Agent
rules), and all hazardous chemicals, activities, or devices that will be used.
2. Identify and assess the risks involved in this project.
3. Describe the safety precautions and procedures that will be used to reduce the risks.
4. Describe the disposal procedures that will be used (when applicable).
5. List the source(s) of safety information.
To be completed and signed by the Designated Supervisor (or Qualified Scientist, when applicable):
I agree with the risk assessment and safety precautions and procedures described above. I certify that I have
reviewed the Research Plan and will provide direct supervision.
Designated Supervisors Printed Name
Signature
Position & Institution
Date of Review (mm/dd/yy)
Phone or email contact information
Experience/Training as relates to the students area of research
Human Participants Form (4)
Required for all research involving human participants not at a Regulated Research Institution. If at a Regulated Research
Institution, use institutional approval forms for documentation of prior review and approval.
(IRB approval required before experimentation.)
Irish Joy R. Delos Santos, Erika Mae de Guia, LennieMay Galope
Students Name(s)
Narra Sawdust as an Alternative Varnish
Title of Project
Benilda Galope
Adult Sponsor
Contact Phone/Email
Must be completed by Student Researcher(s) in collaboration with the Adult Sponsor/Designated Supervisor/Qualified
Scientist:
1. I have submitted my Research Plan which addresses ALL areas indicated in the Human Participants
Section of theResearch Plan Instructions.
2.
I have attached any surveys or questionnaires I will be using in my project.

o Any published instrument(s) used was /were legally obtained.
3.
I have attached an informed consent that I would use if required by the IRB.
4. Yes No Are you working with a Qualified Scientist? If yes, attach the Qualified Scientist Form 2
Must be completed by Institutional Review Board (IRB) after review of the research plan. The submitted Research
Plan must address all areas indicated on the Human Participants section of the Research Plan Instructions.
Check one of the following:

o Research project requires revisions and is NOT approved at this time. IRB will attach document indicating
concerns and/or requested revisions.
o Research project is Approved with the following conditions below: (All 5 must be answered)
1. Risk Level (check one) :
Minimal Risk
More than Minimal Risk

2. Qualified Scientist (QS) Required:
Yes
No
3. Written Minor Assent required for minor participants:
YesNoNot applicable (No minors in this study)
4.
Written Parental Permission required for minor participants:

YesNoNot applicable (No minors in this study)
5.
Written Informed Consent required for participants 18 years or older:

YesNoNot applicable (No participants 18 yrs or older in this study)
IRB SIGNATURES (All 3 signatures required) None of these individuals may be the adult sponsor, designated
supervisor, qualified scientist or related to (e.g., mother, father of) the student (conflict of interest).
I attest that I have reviewed the students project and agree with the above IRB determinations.
Medical or Mental Health Professional (a psychologist, medical doctor, licensed social worker, licensed clinical
professional counselor, physicians assistant, or registered nurse)
Printed Name
Degree/Professional License
Signature
Date of Approval (Must be prior to experimentation.)
Educator
MS. BENILDA GALOPE

Printed Name
Degree
Signature
Date of Approval (Must be prior to experimentation.)
School Administrator
MR. MARINO GALIMBA

Printed Name
Signature:
Degree
Human Informed Consent Form

Instructions to the Student Researcher(s): An informed consent/assent/permission form should be
developed in consultation with the Adult Sponsor, Designated Supervisor or Qualified Scientist.
This form is used to provide information to the research participant (or parent/guardian) and to document
written informed consent, minor assent, and/or parental permission.
When written documentation is required, the researcher keeps the original, signed form.
Students may use this sample form or may copy ALL elements of it into a new document.
If the form is serving to document parental permission, a copy of any survey or questionnaire must be attached.
Student Researcher(s):
Title of Project:
I am asking for your voluntary participation in my science fair project. Please read the following information
about the project. If you would like to participate, please sign in the appropriate box below.
Purpose of the project:
If you participate, you will be asked to:
Time required for participation:
Potential Risks of Study:
Benefits:
How confidentiality will be maintained:
If you have any questions about this study, feel free to contact:
Adult Sponsor: ANN MARIE J. BALTAZAR Phone/email: 09155210945/annmarie_baltazar@yahoo.com
Voluntary Participation:
Participation in this study is completely voluntary. If you decide not to participate there will not be any negative
consequences. Please be aware that if you decide to participate, you may stop participating at any time and
you may decide not to answer any specific question.
By signing this form I am attesting that I have read and understand the information above and I freely
give my consent/assent to participate or permission for my child to participate.
Adult Informed Consent or Minor Assent
Printed Name of Research Participant:
Date Reviewed & Signed:

Signature:
Parental/Guardian Permission (if applicable)
Date Reviewed & Signed: August 20, 2013
Parent/Guardian Printed Name:
Signature:
P a g e | 25
CERTIFICATION AS TEAM PROJECT
THIS IS TO CERTIFY that the project submitted by

(Team Leader)
-______________________________________________________
(Member)
Of
(Member
as official entry to
(School)
2014-2015 Intel Philippine Science Fair was conducted/experimented by the
abovementioned
Three (3) students.

Printed Name and Signature of Adviser/Adult Sponsor
NOTED:
MRS. PACITA L. BASABAS

___________________
Printed Name and Signature of Principal or
Head of S and T Department
Date
Signed:
2011-2012 Intel Philippine Science Fair

RESEARCH PAPER
PART I: BACKGROUND INFORMATION
1.Students name
2.a) Team Leaders Name
b) Member
c) Member
Level:
Level:
Level:
Level:
3. School
4. School AddressBagani Campo, Candon City, Ilocos Sur
5. Telephone/Fax Numbers
742-6456
6. Title of Project Tamarind (Tamarindus Indica) Seeds Coffee
7. Project Adviser/Adult Sponsor

Ann Marie J. Baltazar
8. This years experiment began and ended
9. Where did you conduct your lab work?(Check all that apply)
[
] Research Institution [ / ] School
] Field
[ / ] Home
10. Name, address and phone no. of lab work site(s)

Candon National High School Laboratory, Bagani Campo, Candon City, Ilocos Sur
P a g e | 27
Republic of the Philippines

DEPARTMENT OF EDUCATION
Candon City
APPLICATION FORM TEAM PROJECT
Region:
Please Check: Level:

] National
[ / ] Division
] Regional
Cluster
Science Fair Division:
[ / ] Life Sciences [
]1
[ / ]2
] Physical
Sciences
Field of Study/Discipline
1.
Name of Leader
Name
Surname
Name of Member
First Name
Surname
First Name
Surname
First Name
Middle
Middle
Name of Member
Middle
2. Permanent House Address
No.
3. Telephone/Fax No.
Street District
4. Sex
City/Municipality
Province
5. Birth Date
Female
6. School, Address of School
CandonNHS,
Bagani
Campo,
Candon
7. School
Year
Level City, Ilocos Sur
742-6456
Tel. No./ Fax No. of School
8. Title of the Investigatory Project
9. Attach one copy o f accomplished OFFICIAL ABSTRACT FORM: (Not more than 250
words, 1 page)
Noted:
MRS. PACITA L. BASABAS
Printed Name and Signature of

Principal or Head of
Printed Name and Signature of the
Project Leader
Science Department
ANN MARIE J.
Project Adviser/Adult Sponsor
Date Submitted
CERTIFICATION OF PARENTAL CONSENT

We,
who
parents/ of
are
with residence at
legal
do
hereby certify that we give our full support for our son/ daughter to participate in the 20132014 Intel Philippine Science Fair,
SCHOOL
on
under the
following conditions:
1. Our child will be chaperoned/ escorted by her/ his project adviser;
a. The chaperone will see to the safety, behavior and physical upkeep of our
child as far as humanly possible;
b. Considering the above conditions and the benefits that our child will
derive from his/ her participation in this activity, and realizing that every precaution
will be undertaken by the adviser/ chaperone and your office, we undersigned
parents/ guardian of the above name project investigator do hereby give our consent
for him/ her to participate in the 2010- 2011 Intel Philippine Science Fair. We shall
bring him/ her to the point of official debarkation.
Name & Signature of Father/ Guardian
Name & Signature of Mother
Date of signed
P a g e | 29

We,
parents/ of
who
are
legal
with residence at
do
hereby certify that we give our full support for our son/ daughter to participate in the 20142015 Intel Philippine Science Fair,
SCHOOL
on
under
the following conditions:

Date of signed

We,
who are legal
parents/ of
with residence at
do hereby certify that we give our full support for our son/ daughter to participate in the
2014- 2015 Intel Philippine Science Fair,
SCHOOL
on
under the
following conditions:
Date of signed
P a g e | 31
MEDICAL CERTIFICATE
Date:
THIS IS TO CERTIFY that ________________of Candon National High School has undergone
physical
Examination
(Name of Project Investigator)
(School)
and was found to be physically fit to participate in the 2013-2014 Regional Intel
Philippine Science Fair, on
(Date)
REMARKS :
________________
Examining Physician
License No:
Hospital/Clinic Office: CANDON NATIONAL HIGH SCHOOL CLINIC
Address: BAGANI CAMPO, CANDON CITY
MEDICAL CERTIFICATE
Date:
THIS IS TO CERTIFY that _________________of Candon National High School has undergone
physical
Examination
(School)
(Date)
REMARKS :
_______________
Examining Physician
License No: ____
P a g e | 33
MEDICAL CERTIFICATE
Date:
THIS IS TO CERTIFY that __________________of Candon National High School has

undergone physical
Examination
(School)
(Date)
REMARKS :
_____________
Examining Physician
License No: _________
CERTIFICATION AS OFFICIAL PROJECT

ADVISER
This is to certify that MS. ANN MARIE J. BALTAZAR is the Official Project
Adviser/Adult
(Name of Project Adviser)
Sponsor of project TAMARIND (TAMARINDUS INDICA) official entry of Candon

National High School to the 2014-2015 Regional Intel Philippine Science Fair.
(School)
MRS. PACITA L. BASABAS_

Printed Name & Signature of Principal
Date Signed: _________

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Page | 1

OFFICIAL ABSTRACT and CERTIFICATION

Pick one only

Agas-moro (Vernonia cinerea Linn.) Anti-CF (Cold and Fever) Ointment

Candon National High School, Candon City, Philippines

As a part of this research project, the student directly handled, manipulated, or

potentially hazardous biological agents

2. This abstract describes only procedures performed by

5. My display board includes non-published photographs/visual

6. I/we hereby certify that the abstract and responses to the

Planning the investigatory project

Setting the Experiment

Listing of materials needed

Writing the rough draft procedure

Finalizing the experiment

Finalizing the project

Republic of the Philippines

B. STATEMENT OF THE PROBLEM

D. SIGNIFICANCE OF THE STUDY

E. SCOPE AND LIMITATIONS

The were washed and

MATERIALS AND METHODS

RESULTS & DISCUSSION

Table 2. Effectiveness of the Tamarind

Table 3. The number of trial and corresponding results.

CONCLUSION AND RECOMMENDATIONS

Checklist for Adult Sponsor (1)

o Continuation/Research Progression Form (7) (when applicable)

Qualified Scientist Form (2) (when applicable)

Student Checklist (1A)

School Phone: 742-6456

School Address: Bagani Campo, Candon City

Ann Marie J. Baltazar

5) Is this a continuation/progression from a previous year? Yes No

6) This years laboratory experiment/data collection: (must be stated (mm/dd/yy))

Start Date: (mm/dd/yy)

End Date: (mm/dd/yy)

Research Institution School

8) List name and address of all non-school work site(s):

Research Plan Instructions

Explain potential impact or contribution this research may have

Detail all procedures to be used

Detail animal numbers, species, strain, sex, age, source, etc.

Describe housing and oversight of daily care

Discuss disposition of the animals at the termination of the study

Describe Biosafety Level Assessment process and resultant BSL determination

Give source of agent, source of specific cell line, etc.

Detail safety precautions

Discuss methods of disposal

Describe Risk Assessment process and results

Detail chemical concentrations and drug dosages

Describe safety precautions and procedures to minimize risk

Discuss methods of disposal

Approval Form (1B)

1) To Be Completed by Student and Parent

Students Printed Name

Date Acknowledged (mm/dd/yy)

Parent/Guardians Printed Name

Date Acknowledged (mm/dd/yy)

2) To be completed by the local or affiliated Fair SRC

b) Required for research conducted at all Regulated

SRC/IRB Chairs Printed Name

Date of Approval (mm/dd/yy)

3) Final Intel ISEF Affiliated Fair SRC Approval