Custom form help


Hi there,

Can we ask if any devs here can help with a piece of custom code we have been building and need some help to finish it? Although the design is done, we can't get it to work when collecting the data input. 

It's for a custom, inline, one-field form, where we want the user to enter their email address now, and it goes to Mailchimp or Then, when they click 'Get Started, they are directed to another page. 

If anyone can help or advise on someone or a company that can, that would be awesome!