CDBS Print

Federal Communications Commission
Washington, D.C. 20554

Approved by OMB
3060-0084 (June 2002)

FCC 323-E

FOR FCC USE ONLY

Ownership Report For Noncommercial Educational Broadcast Station

Read INSTRUCTIONS Before Filling Out Form

FOR COMMISSION USE ONLY
FILE NO.
BOA - 20090928AGK

Section I - General

1.	Legal Name of the Licensee/Permittee CLOVER PARK TECHNICAL COLLEGE
	Mailing Address 4500 STEILACOOM BOULEVARD SW
	City TACOMA		State or Country (if foreign address) WA	ZIP Code 98499 -
	Telephone Number (include area code) 2535895884		E-Mail Address (if available)
	FCC Registration Number: 0001571173	Call Sign KVTI	Facility ID Number 12068
2.	Contact Representative (if other than Licensee/Permittee) JOHN CRIGLER, ESQ.		Firm or Company Name GARVEY SCHUBERT BARER
	Mailing Address
	City		State or Country (if foreign address)	ZIP Code -
	Telephone Number (include area code) 2029657880		E-Mail Address (if available) JCRIGLER@GSBLAW.COM
3.	Name of entity, if other than licensee or permittee, for which report is filed
	Mailing Address
	City		State or Country (if foreign address)	ZIP Code -
	Telephone Number (include area code)		E-Mail Address (if available)

Section II - Ownership Information

All of the information furnished in this Report is accurate as of 09/01/2009 (Date must comply with 47 C.F.R. Section 73.3615(d), i.e., information must be current within 60 days of filing of this report, when 4(a) below is checked.)

This Report is filed for (check one)

a.		Biennial	b.		Transfer of Control or Assignment of License/Permit		c.		Other
d.	Amendment to pending application

for the following stations:

[Enter Station Information]

Station List

This Report is filed for the following stations:

Call Letters	Facility ID Number	Location (City/State)	Class of service
KVTI	12068	TACOMA WA	FM

List all contracts and other instruments required to be filed by 47 C.F.R. Section 73.3613. (Only licensees, permittees, or a reporting entity with a majority interest in or that otherwise exercises de facto control over the subject licensee or permittee shall respond.)

[Enter Contract/Instrument Information]

Is the governing board directly or indirectly under the control of another entity?	Yes No
If Yes, is a separate FCC Form 323-E submitted for such entity?	Yes No

List officers, members of governing board, and holders of 1% or more ownership interest, if any. Use one column for each individual or entity. Attach supplemental pages, if necessary.

[Enter Owner Information]

Owner Information

List officers, members of governing board, and holders of 1% or more ownership interest, if any. Use one column for each individual or entity. Attach supplemental pages if necessary.
(Read carefully - The numbered items below refer to line numbers in the following table.)

a. Name and address of officer, member of governing board, and holders of 1% or more ownership interest (if other than individual also show name, address and citizenship of natural person authorized to vote the interest). List officers first, then board members, and thereafter, holders of 1% or more ownership interest, if any.
b. Citizenship.
c. Office held.
d. Percent of interest held.
e. Principal profession or occupation.
f. By whom appointed or elected.
g. Existing interests in any other broadcast station, including the nature and size of such interests.

a. Name and Address.	MARY MOSS, 7115 87TH AVENUE CT. SW, LAKEWOOD, WA 98498-4093
b. Citizenship.	US
c. Office held.	CHAIR
d. Percent of interest held.	20.00
e. Principal profession or occupation.	PUBLIC RELATIONS
f. By whom appointed or elected.	GOVERNOR OF WASHINGTON
g. Existing interests	NONE

a. Name and Address.	BRUCE LACHNEY 7312 385TH ST. E EATONVILLE, WA 98328
b. Citizenship.	US
c. Office held.	TRUSTEE
d. Percent of interest held.	20.00
e. Principal profession or occupation.	COMMERCIAL PILOT
f. By whom appointed or elected.	GOVERNOR OF WASHINGTON
g. Existing interests	NONE

a. Name and Address.	ROBERT LENIGAN, PH.D. 10636 LAKE STEILACOOM DRIVE, SW, LAKEWOOD, WA 98498
b. Citizenship.	US
c. Office held.	TRUSTEE
d. Percent of interest held.	20.00
e. Principal profession or occupation.	PSHYCHOLOGIST
f. By whom appointed or elected.	GOVERNOR OF WASHINGTON
g. Existing interests	NONE

a. Name and Address.	MARK MARTINEZ 3049 S 36TH ST., SUITE 220, TACOMA, WA 98409
b. Citizenship.	US
c. Office held.	TRUSTEE
d. Percent of interest held.	20.00
e. Principal profession or occupation.	COUNTY OFFICIAL
f. By whom appointed or elected.	GOVERNOR OF WASHINGTON
g. Existing interests	NONE

a. Name and Address.	SHAUNA RAE WEATHERBY, 5710 69TH COURT WEST, UNIVERSITY PLACE, WA 98467
b. Citizenship.	US
c. Office held.	TRUSTEE
d. Percent of interest held.	20.00
e. Principal profession or occupation.	NURSE PRACTITIONER
f. By whom appointed or elected.	GOVERNOR OF WASHINGTON
g. Existing interests	NONE

a. Name and Address.	JOHN W. WALSTRUM, PH.D. 8111 48TH AVENUE SW, LAKEWOOD, WA 98499
b. Citizenship.	US
c. Office held.	COLLEGE PRESIDENT AND BOARD SECRETARY
d. Percent of interest held.	0.00
e. Principal profession or occupation.	COLLEGE PRESIDENT
f. By whom appointed or elected.	BOARD OF TRUSTEES
g. Existing interests	NONE

SECTION III - CERTIFICATION

I certify that I am COLLEGE PRESIDENT & BOARD SECRETARY

(Official Title)

of CLOVER PARK TECHNICAL COLLEGE

(Exact legal title or name of respondent)

and that I have examined this Report and that to the best of my knowledge and belief, all statements in this Report are true, correct and complete.

(Date of certification must be within 60 days of the date shown in Question 4, Section II and in no event prior to that date.)

Signature JOHN W. WALSTRUM, PH. D.	Date 09/18/2009
Telephone Number of Respondent (Include area code) 2535895884

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503).

Exhibits