I'm totally confused

I need to insert an opt-in box on a page. I am trying to do it as a simple snippet, which may not be correct. I tried fiddling with advanced, which seems more logical, and got no place.

Here’s my URL: http://ecofriendlyhomeproducts.com/save-money/

The input boxes appear detached from the form. That is, the spaces on the form where “name” and “email” should be don’t work, but boxes that do work appear under the form.

Actually, I did try entering the HTML directly on the page, but it’s impossible to input anything on the resulting form.

Lest you think that the HTML itself is faulty, I have successfully used the same HTML on a different site with a different theme that has its own built-in short-code generator. See http://eco.allpurposeguru.com

The problem, therefore, is that I have no idea how to use your plugin. The introductory video gives me no idea how to make short-codes that I can imagine ever actually using.

http://wordpress.org/plugins/shortcodes-ui/