Got it!
[guest_step_1.tpl]
<h1 class="heading1">
<span class="maintext"><?php echo $heading_title; ?></span>
<span class="subtext"></span>
</h1>
<?php if ($success) { ?>
<div class="alert alert-success">
<button type="button" class="close" data-dismiss="alert">×</button>
<?php echo $success; ?>
</div>
<?php } ?>
<?php if ($error_warning) { ?>
<div class="alert alert-error alert-danger">
<button type="button" class="close" data-dismiss="alert">×</button>
<?php echo $error_warning; ?>
</div>
<?php } ?>
<div class="contentpanel">
<?php echo $form['form_open']; ?>
<h4 class="heading4"><?php echo $text_your_details; ?></h4>
<div class="registerbox form-horizontal">
<fieldset>
<div class="form-group ">
<label class="control-label col-md-4">First Name:</label>
<div class="input-group col-md-6">
<input type="text" name="firstname" id="guestFrm_firstname" value="" placeholder="" class="form-control " />
<span class="input-group-addon"><span class="required">*</span></span>
</div>
<span class="help-block"></span>
</div>
<div class="form-group ">
<label class="control-label col-md-4">Last Name:</label>
<div class="input-group col-md-6">
<input type="text" name="lastname" id="guestFrm_lastname" value="" placeholder="" class="form-control " />
<span class="input-group-addon"><span class="required">*</span></span>
</div>
<span class="help-block"></span>
</div>
<div class="form-group ">
<label class="control-label col-md-4">E-Mail:</label>
<div class="input-group col-md-6">
<input type="text" name="email" id="guestFrm_email" autocorrect="off" autocapitalize="off" value="" placeholder="" class="form-control " />
<span class="input-group-addon"><span class="required">*</span></span>
</div>
<span class="help-block"></span>
</div>
<div class="hide">
<div class="form-group ">
<label class="control-label col-md-4">State</label>
<div class="input-group col-md-6">
<input type="text" name="zone_id" id="guestFrm_zone_id" value="3624" placeholder="" class="form-control " />
<span class="input-group-addon"><span class="required">*</span></span>
</div>
<span class="help-block"></span>
</div>
<div class="form-group ">
<label class="control-label col-md-4">Country</label>
<div class="input-group col-md-6">
<input type="text" name="country_id" id="guestFrm_country_id" value="223" placeholder="" class="form-control " />
<span class="input-group-addon"><span class="required">*</span></span>
</div>
<span class="help-block"></span>
</div>
</div>
</fieldset>
</div>
<div class="hide">
<h4 class="heading4"><?php echo $text_your_address; ?></h4>
<div class="registerbox form-horizontal">
<fieldset>
<?php
$field_list = array('company' => 'company',
'address_1' => 'address_1',
'address_2' => 'address_2',
'city' => 'city',
'zone' => 'zone_id',
'postcode' => 'postcode',
'country' => 'country_id',
);
foreach ($form['fields']['address'] as $field_name=>$field) {?>
<div class="form-group <?php if (${'error_'.$field_name}) echo 'has-error'; ?>">
<label class="control-label col-md-4"><?php echo ${'entry_'.$field_name}; ?></label>
<div class="input-group col-md-6">
<?php echo $field; ?>
</div>
<span class="help-block"><?php echo ${'error_'.$field_name}; ?></span>
</div>
<?php }
echo $this->getHookVar('address_entry_section'); ?>
<div class="form-group">
<label class="control-label col-md-4"></label>
<div class="input-group col-md-6">
<?php echo $form['shipping_indicator']; ?>
</div>
</div>
</fieldset>
</div>
<!-- start shipping address -->
<div id="shipping_details" style="<?php echo ($shipping_addr) ? 'display:block;' : 'display:none;' ?>">
<h4 class="heading4"><?php echo $text_shipping_address; ?></h4>
<div class="registerbox form-horizontal">
<fieldset>
<?php
$field_list = array('firstname' => 'shipping_firstname',
'lastname' => 'shipping_lastname',
'company' => 'shipping_company',
'address_1' => 'shipping_address_1',
'address_2' => 'shipping_address_2',
'city' => 'shipping_city',
'zone' => 'shipping_zone',
'postcode' => 'shipping_postcode',
'country' => 'shipping_country',
);
foreach ($form['fields']['shipping'] as $field_name=>$field) {
?>
<div class="form-group <?php if (${'error_'.$field_id}) echo 'has-error'; ?>">
<label class="control-label col-md-4"><?php echo ${'entry_'.$field_name}; ?></label>
<div class="input-group col-md-6">
<?php
echo $field;
?>
</div>
<span class="help-block"><?php echo ${'error_'.$field_id}; ?></span>
</div>
<?php
}
?>
</fieldset>
</div>
</div>
<!-- end shipping address -->
</div>
<div class="form-group">
<div class="col-md-12 mt20">
<button class="btn btn-orange pull-right lock-on-click" title="<?php echo $form['continue']->name ?>" type="submit">
<i class="fa fa-arrow-right"></i>
<?php echo $form['continue']->name ?>
</button>
<a href="<?php echo $back; ?>" class="btn btn-default mr10" title="<?php echo $form['back']->text ?>">
<i class="fa fa-arrow-left"></i>
<?php echo $form['back']->text ?>
</a>
</div>
</div>
</form>
</div>
<script type="text/javascript">
$('#guestFrm_shipping_indicator').change( function(){
(this.checked) ? $('#shipping_details').show() : $('#shipping_details').hide();
});
<?php $cz_url = $this->html->getURL('common/zone', '&zone_id='. $zone_id); ?>
$('#guestFrm_country_id').change(function() {
$('select[name=\'zone_id\']').load('<?php echo $cz_url;?>&country_id=' + $(this).val());
});
$('select[name=\'zone_id\']').load('<?php echo $cz_url;?>&country_id='+$('#guestFrm_country_id').val());
<?php $cz_url = $this->html->getURL('common/zone', '&zone_id='. $shipping_zone_id); ?>
$('#guestFrm_shipping_country_id').change(function() {
$('select[name=\'shipping_zone_id\']').load('<?php echo $cz_url;?>&country_id=' + $(this).val());
});
$('select[name=\'shipping_zone_id\']').load('<?php echo $cz_url;?>&country_id='+$('#guestFrm_shipping_country_id').val());
</script>