Simple Order Form Redesign Needed

Right now my company sells information products using a self hosted order form that links to a one click upsell that my programer designed. This form collects shipping details and information about the customer. We need this order form redesigning so that the different elements or in different places on the page. I'll provide a sample order form to model and then I want you to create us a version that looks almost identical. Currently when the form is completed it sends an order to our shopping cart. This order is for a "product" and a "subscription". We want to give the customer the option of NOT ordering the subscription. This will involve adding a checkbox to the order form, and when this checkbox is unticked the form will send an order to the shopping cart for a product that does NOT include the subscription. This is a lot more simple that in sounds and I can provide an example of someone else who is doing this right now. This new order form must be then made to work with our script, so you must simply update our existing form and then check it still works well. This is not a complicated job for someone who knows what they are doing. Please only bid if you can do this fast and if you have experience of this type of work.