I need a Email Sign Up Form on my website homepage

Hi I have a website and I need a Sign Up Form on the homepage of my website for my visitors to enter their email address to sign up for my newsletter. The emails that sign up will go to my iContact account so you will have to use the iContact html code that I will provide to use as the blank space where people will enter their email. The code that i will give you will take care of the email sign up process. The reason I need you is because I want to add the contact form on the bottom of my homepage. Here is an example of how I want the Sign up form to look and where I would like it placed on my website. Example Website: [login to view URL] If you look at the website I provided you can see the contact Form on the bottom of the page. It also remains visible when you scroll through the homepage. That is what I am looking for. If this is something you can do place a bid. I will provide you the html code for my icontact account. then I will need you make adjustments to the coding if needed and tell me where to place that coding on my wordpress website to make it look like the example website shown above.