* Denotes required fields
First Name: *
Last Name: *

Preferred Username: * Use your 6 digit OHSAA #, if available
Preferred Password: * Must be 6 or more characters in length
Re-type Password: *

OHSAA #: *

Mailing Address: *
City: *
State: *
Zip Code: *
E-Mail Address: *
Home County: *
Home Phone #: (xxx-xxx-xxxx) *
Work Phone #: (xxx-xxx-xxxx) *
Cell Phone #: (xxx-xxx-xxxx) *

Please select only those sports which you officiate, leave all others blank: *
Baseball: Softball:
Basketball: Football:
Soccer: Field Hockey:
Track & Field: Volleyball:
Wrestling: Swimming/Diving:

Please list all local associations to which you belong:

Referred by (ex. Association meeting, an Official, mailings, etc.)?

Other Comments:

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