Supreme Court Rules 1937—Form 3.5
(see o 76 r 9)
Adoption order

In the Supreme Court of the Australian Capital Territory

No		of (year)

Adoption Act 1993

In the adoption of (full name to be given to the child)
Judge:
Date of order:
Originating process:
Attendance:
Affidavits read:
Other matters:

The Court orders that:
1	The child become, by this order, the adopted child of [full name of each adoptive parent]. 
2	The child bear, by this order, the following name: [full name to be given to adopted child]. 
3	[Any further orders].
Date entered:
Signature of Registrar:

Endnote
1	This form was originally in the Supreme Court Rules 1937.  Under the Court Procedures Act 2004 A2004-59, pt 8, the form became a form approved under that Act. 

©  Australian Capital Territory 2005