Zoological Parks and Gardens Board established under Part 2 of the Zoological Parks and Gardens Act 1995. 1 Regulation 10 43(2) 2005 (a) *To the Chief Executive Officer of the council of the municipal district of [insert being the municipal district in name of municipal district], which the mother of the child usually resides. or (b) *[If To the Chief Executive Officer of the council of (a) is not known] the municipal district of [insert being the name of municipal district], municipal district in which the birth occurred. or (c) *[If To the the mother of the child usually resides outside Victoria] Secretary to the Department of Education and Training. Full name of mother: *Any other name(s) by which the mother is known: Home address: Telephone number: Gave birth to a child: *Male/*Female/*Other *Live born/*Stillborn
Zoological Parks and Gardens Board established under Part 2 of the Zoological Parks and Gardens Act 1995. 1 Regulation 10 43(2) 2005 (a) *To the Chief Executive Officer of the council of the municipal district of [insert name of municipal district], being the municipal district in which the mother of the child usually resides. or (b) *[If (a) is not known] To the Chief Executive Officer of the council of the municipal district of [insert name of municipal district], being the municipal district in which the birth occurred. or (c) *[If the mother of the child usually resides outside Victoria] To the Secretary to the Department of Education and Training. Full name of mother: *Any other name(s) by which the mother is known: Home address: Telephone number: Gave birth to a child: *Male/*Female/*Other *Live born/*Stillborn