The security deposits will be refunded after the onsite staff verifies that all damages and extra charges
have been settled. Verification of costs can take up to 3 months. The cost of repairs and unsettled bills
will be deducted from your deposits. To be eligible for the refund, students must return the completed
KEI Program Evaluation and the KEI Release Form within 60 days of the program end date.
Refunds will be mailed to the student’s permanent address, as indicated on the Application Form, unless a
different address is specified below. Students using a KEI Payment Plan to pay a portion of the KEI
tuition will have the refund amount deducted from the last scheduled payment(s), if applicable. Students
who do not pay their program fee or payment plan installments by the set deadline dates forfeit the
security deposit and remain liable for any remaining balance owed.
Print the person’s name that should appear on the refund check.
First Name: ______________________ MI: _____
Last Name: ________________________________
Please indicate the address where you want KEI to mail your refund statement and check.
Attention of: ___________________________
Address 1: _____________________________
Zip/Postal Code: ________________________
By submitting this form, I release and forever discharge KEI and its heirs, executors, administrators,
successors and assigns, of and from all, and all manner of action and actions, cause and cause of action,
suits, debts, dues, sums of money, accounts, reckoning, bonds, bills, specialties, covenants, contracts,
controversies, agreements, promises, variances, trespasses, damages, judgments, executions, claims, and
demands whatsoever in law or in equity.
_______(day) _____________(month), __________ (year)
Please return this completed form to KEI along with your Program Evaluation and KEI Release form.