[jeroen]

I started writing down some critique, but I think I can summarise: polish it. UI elements are not aligned, buttons don't work and "mm" doesn't seem like a valid entry for the month-field.

Oh, and more information about your product and less asking for information (phone nr?) might make people more inclined to register.

[andrewljohnson]

mm is an extremely common placeholder for months in a date.

[jeroen]

Sure, but what is it doing in the UI? It isn't a valid option for the selection.

[tallasif]

Thanks for your feedback guys. I think jeroen is right, It should just clearly say month / year, as the whole idea of the application is to make things simple. instead of mm/yyyy which is very techie and may not be obvious at all to the end user.