Uniquely crafted from recycled antique ivory piano keys! PLEASE NOTE: Due to new federal regulations, effective on July 6, 2016 we CANNOT ship recycled antique ivory piano key items to addresses outside of the state of Missouri. If you place an order to be shipped outside of Missouri, we offer bookmarks made with old (not yet antique!) SYNTHETIC keys---they are old, hand-etched, and look much the same as ivory. Each is mounted on art-board covered with handmade paper, complete with a leather ‘ribbon’ and a silver bead. We’ve had great response to this recycled-material.