Try to find out what would you change to make this form cleaner. Imagine that you can’t take any field out, you can only reorganize the layout. The form must be in HTML. You can apply some JS but not too much (it must be accessible for people who doesn’t use JS)
I’m working on redesign of this page and I can use some help for sure. I’d love to get feedback from people working around Usability on a daily basis. If you know such person or you’re such person, please help me!