Hexicons waiting page

I recently bought hexicons.net for my coming set of icons. The header is an image, but the form isn't. It is a coded form based on this psd http://drbl.in/KZR I made a while ago. It's not the same because I couldn't use an overlay style unfortunately on CSS, so I chose a blue color instead for the inset shadow.

Anyway this is a good test for me, so if you have any advice on the form especially or any other part of this page, they are welcome.

Expect a release this month of the form .psd and maybe the code.

Check the full page live: http://hexicons.net/