What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you’re getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you’d like help immediately, feel free to search for a similar question, or submit your question or concern.
From the screenshot it seems that your form is still empty. You need to add fields to your form and only then do the mailchimp integration. Then you will choose which of your form's field will be used for mailchimp to capture emails.
You can also share with us your form's url so we can be of more asistance.
Let us know if further assistance is needed.