I, the undersigned, declare that the information on this application form is accurate and true and I agree to abide by the rules and regulation of Genting Inti International College.
我，谨此签署
，
上填写之资料皆属真
无误，并同意遵守云顶英
际学院守则。
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为奴十
Done and signed at Marksville, parish of Avoyelles, this fourth day of January, one thousand eight hundred and fifty-three, in the presence of the undersigned, legal and competent witnesses, who have also hereto signed.
1853 1 月 4 
， 在 Avoyelles 
Marksville 
成并签署，在场的还有以下签署人、合法和有能力的证人， 他们也已在此签署。
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译
