$15 Form Redesign Contest

[egjeff4]

I would like the form portion of this site redesigned to look not as basic....

http://homemortgageexperts.net/georgia-home-refinancing/

I don't have any ideas...but, i guess making the page pop with some more designs....or some nice .css affects would help....nothing crazy....just something to make the page look better...

$15 for winning contestant....