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.
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.
真
无
，
意遵守云顶英迪国际学院守则。
纸的下
， 
Avoyelles 教区 Marksville 完成并
，
的还有
