Complete this form and press "Submit". 
Alan Pierce will contact you to confirm your desired specifications
and payment arrangement.

Name

Mailing Address

Contact Number

Preferred Time To Contact

E-mail Address

I have a drawing, picture, or sample to send for duplication

Yes No

Baton Material

Graphite
Balsa Wood
Other (specify)

Baton Shaft Length

14.5" (36.83cm)
15" (38.10cm)
16" (40.64cm)
Other (specify)

Handle Material

Cork
Wood
Other (specify)

Handle Shape

Round
Wide
Other (specify)

Embedded Material

Colored Stone (indicate color preference)
Birthstone (indicate gem)
Initials (specify placement order)
Other (specify)

Further Comments or Specifications