Please print using block letters and complete all sections. Payment by credit card is accepted. Personal cheques will not be accepted for Urgent Applications. Birth certificates are private and are only available to the person named on the certificate, their parents or legal guardian.
Identification is required for all applicants.
These may be presented in person at the Registry or photocopied and posted with this application. A text version of this form is also available. Prices current as at August 2000 are GST Exempt and are subject to changes without further notice. American Express Bankcard Mastercard Visa Please allow 21 days for delivery. Photocopies of this application can be used to order additional Commemorative Birth Certificates for other family members and friends.