12.1

<div class="form-group">
 <button type="button" class="btn btn-lg btn-feedback" data-toggle="modal" data-target="#feedbackModal">Feedback</button>
</div>
<div id="feedbackModal" class="modal fade " role="dialog">
 <div class="modal-dialog">
     <div class="modal-content">
     <div class="modal-header text-center">
         <button type="button" class="close" data-dismiss="modal">
             <span class="hyicon hyicon-close"></span>
             <span class="sr-only">Close</span>
         </button>
         <h2>Submit Feedback to SAP Hybris</h2>
         <h4>Tell us how we can improve</h4>
     </div>
     <div class="modal-body">
         <div class="form-group">
             <label for="email">Email</label>
             <input type="text" class="form-control input-lg" id="email" placeholder="Optional">
             <span class="help-inline">
                 <span class="hyicon hyicon-helpoff help-icon-inline"></span>
                 <span class="help-block-inline">Your email address is used only if we need to contact you for more details.</span>
             </span>
         </div>
         <div class="form-group">
             <label for="subject">Subject</label>
             <select name="" id="issueType" class="form-control input-lg">
                 <option value="Improvement" selected>Improvement</option>
                 <option value="New Feature">New Feature</option>
                 <option value="Bug">Bug</option>
             </select>
         </div>
         <div class="form-group feedbackform-textarea">
             <label class="desc" for="suggestions">Suggestions / Improvements <span class="req">*</span> </label>
             <textarea id="suggestions" class="textarea form-control" spellcheck="true" rows="3" cols="50" tabindex="1" required=""></textarea>
         </div>
         <p class="text-muted">Other ways to provide feedback:</p>
         <h3>Talk to Experts</h3>
         <p>Use <a href="https://experts.hybris.com/spaces/151/index.html" target="_blank"><strong>hybris Experts Forum</strong></a> to get help from y-Experts</p>
     </div>
     <div class="modal-footer">
         <button data-dismiss="modal" tabindex="5" class="btTxt btn btn-lg btn-subordinate">CANCEL</button>
         <button id="saveForm" tabindex="6" class="btTxt submit btn btn-lg btn-primary">SUBMIT FEEDBACK</button>
     </div>
     <div id="complete"></div>
 </div>
</div>