Feedback Modal Window

A simple "feedback" modal window for a client. Gradient'ed background uses a tiling image, and box shadow used for inputs. The bottom textarea is in the mouseover / focused state. Used some simple custom jQuery to clear the inputs when clicked (A-la HTML5 Placeholder attribute).

If the user tries to submit the form with the default text in the boxes, the relevant boxes pulsate with a highlight effect to let the user know the contents need to be changed before they can submit (I like this ;))

Would love some feeback and opinions :)