You need to follow certain steps

To replicate the newsletter form as this :

Step 1: Install the mailchimp plugin:

Step 2: Create your account in and create your API key and enter that API key to get connected with mailchimp plugin, here is the screenshot:

Once you save the changes your status would be connected after sometime:

Step 3: Go to form option and put the below code in the form markup area:

<p style="color:#bcbec0;">Lorem ipsum dolor sit amet, teft consecte
tur adipiscing elit ut eunt.</p>
<p class="newsletter_form">
<input type="email" id="imedica_newsletter_email" name="EMAIL" placeholder="Your email address" required />
<input type="submit" id="imedica_newsletter_submit" value="subscribe" />

Step 4: Then go to the appearance–>widget and drag the Mailchimp widget to your desired footer area:

Hope this helps!