Daily UI - Sign Up #001

Hello Dribbble users,
This is my first post here. I have decided, officially to take part on Daily UI project. Check out my #001 work on #dailyui.

So let's get started! I saw that vine.co website, doesn't have a sign up form. So I just took a shot, #001 - Sign Up form. Big size here: http://bit.ly/dailyui-2
#dailyui

Notice: I'm not a professional designer, just an amateur. So don't hesitate to give me some feedback.
See you soon!