I wanted to design my own subscribe and connect box, which can be seen here; http://tpahpdspremade.blogspot.com

After I put in the proper links through image-maps for the social media icons, I want to add a simple email subscription box below where it says "get the latest from the flower city fashionista sent straight to your inbox" to the code.

If anyone may know what kind of html code I may need to create this into my design (shown below) it would be greatly appreciated.