[Steven Zahm]

@ Jim

My guess is the theme is floating inputs, by default inputs are not floated. That said, this works for be:

#cn-form .address-country,
#cn-form .address-geo {
    display: none;
}

Best guess without knowing what exactly is affecting the layout is to add this:

#cn-form .address-region {
    clear: both
}

Hope that helps!