Titleholder notice of intent

You can let us know that you are interested in running for an Oregon State Leather Title. Filling in this form will allow us to contact you via email when our applications for the upcoming title year are live.

Legal Name

First Name

Last Name

Scene Name

First Name

Last Name

Which name do you prefer we use when contacting you?

Legal Name

Scene Name

Phone

(###)

###

####

I am 21 years of age or older and eligible to hold an OSL title.

Birthdate

YYYY

Titleholder notice of intent

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