Wedgistry: Check Out Form

Hi All,
The Wedgistry adventure continues! This time, check-out form.
As usual, credits to @Afterglow for the original inspiration.

Check out other Wedgistry shots here: https://dribbble.com/shots/6179013-Wedgistry-Pagination
https://dribbble.com/shots/6140902-Wedgistry

As usual, comments, suggestions, critiques encouraged.
Press 'L" for some love.
~T