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font-size: 12px;font-family: Arial,Helvetica,FreeSans,'sans - serif';}
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<div id='feedback-main-div' style='font-size: 12px; font-family: Arial,Helvetica,FreeSans,sans-serif'>
<div id='feedback-error'></div>
<form enctype='multipart/form-data' id='feedback-form' name='feedback-form' target='feedback-response' method='post' action='http://jira.teamlead.ru/plugins/servlet/feedback/create'>
<input type='hidden' name='form-index' id='form-index' value='5'/>

<div><select id='feedback-component' name='feedback-component'>
<option value='' selected >Выберите тему обращения -------------</option>
<option value='17060'>Вопрос в бухгалтерию</option>
<option value='14268'>Консультация по продуктам и услугам</option>
<option value='14265'>Оценка проекта или разработки</option>
<option value='14263'>Покупка продуктов и услуг</option>
<option value='14267'>Сотрудничество</option>
<option value='17066'>Прочие вопросы</option>
</select>
</div>
 
<br>

<div><select id='customfield_14440' name='customfield_14440'>
<option value='' >Выберите услугу, с которой связан вопрос</option>
<option value='11980'>Поставка ПО</option>
<option value='11981'>Тренинг</option>
<option value='11982'>Внедрение</option>
<option value='11983'>Разработка</option>
<option value='11984'>Поддержка</option>
<option value='11985'>Хостинг</option>
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<div><input type='text' id='feedback-summary' name='feedback-summary' size='72' placeholder='Тема обращения' value=''/></div>


<br>


<div><TEXTAREA id='feedback-body' name='feedback-body' COLS='62' ROWS='5' placeholder='Тут можно указать подробности...'></TEXTAREA></div>
 
<br>

<div class='checkbox'>
<input type='checkbox' value='11484' name='customfield_13241' id='customfield_13241-1' class='checkbox'>
<label for='customfield_13241-1'>JIRA</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11485' name='customfield_13241' id='customfield_13241-2' class='checkbox'>
<label for='customfield_13241-2'>Confluence</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11486' name='customfield_13241' id='customfield_13241-3' class='checkbox'>
<label for='customfield_13241-3'>Crowd</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11487' name='customfield_13241' id='customfield_13241-4' class='checkbox'>
<label for='customfield_13241-4'>FishEye</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11488' name='customfield_13241' id='customfield_13241-5' class='checkbox'>
<label for='customfield_13241-5'>Crucible</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11489' name='customfield_13241' id='customfield_13241-6' class='checkbox'>
<label for='customfield_13241-6'>Bamboo</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11492' name='customfield_13241' id='customfield_13241-8' class='checkbox'>
<label for='customfield_13241-8'>GreenHopper</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11493' name='customfield_13241' id='customfield_13241-9' class='checkbox'>
<label for='customfield_13241-9'>Team Calendars</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='11987' name='customfield_13241' id='customfield_13241-12' class='checkbox'>
<label for='customfield_13241-12'>Bonfire</label>
</div>
<div class='checkbox'>
<input type='checkbox' value='12081' name='customfield_13241' id='customfield_13241-14' class='checkbox'>
<label for='customfield_13241-14'>Stash</label>
</div>

<br>

<input type='text' id='feedback-email' name='feedback-email' placeholder='E-mail для ответа' size='38' value=''/>


<br>
 
<div><input type='file' id='feedback-attachment' name='feedback-attachment' size='38' /></div>


<br>
<input type='button' value=' Задать вопрос ' onclick='addFeedback()'/>
</form></div>
 
<br>

<iframe id='feedback-response' name='feedback-response' frameborder='no' style='display: none' width='450' height='200'></iframe><div id='feedback-new-issue-div'><input type='button' id='feedback-new-issue-button' value='Создать еще запрос'></div><script type='text/javascript'>
jQuery(window).load(function()
{
   jQuery('#feedback-main-div').show();
   jQuery('#feedback-new-issue-div').hide();
   jQuery('#feedback-response').hide();
   jQuery('#feedback-new-issue-button').click(function ()
   {
    jQuery('#feedback-form')[0].reset();
    jQuery('#feedback-main-div').show();
    jQuery('#feedback-new-issue-div').hide();
    jQuery('#feedback-response').hide();
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});

function addFeedback() {
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   var email = jQuery('#feedback-email').val();
   if (summary == '' || email == '')
   {
    var message = '';
    if (summary == '')
    {
     message = message + '<div>Введите тему обращения</div>';
    }
    if (email == '')
    {
     message = message + '<div>Введите E-mail для ответа</div>';
    }
    jQuery('#feedback-error').html(message);
    return false;
}
   jQuery('#feedback-error').html('');
   jQuery('#feedback-main-div').hide();
   jQuery('#feedback-new-issue-div').show();
   jQuery('#feedback-response').show();
   jQuery('#feedback-form').submit();
   return false;
}
</script>