Subscribe form not correct on sign-up page

I installed and began configuring the above plugin. It is not viewing the initial subscribe page (sign-up page) correctly. I have a screenshot I can email, but our site isn't live yet so unless I give you login access, you won't be able to see it.

I have had some issues with other free plugins I tried for this purpose and that's why I ultimately bought this one, hoping it would solve this problem.

I have tried to use the widget in the sidebar and also in the page using widgetized pages. In both cases, I am getting the same problem of the subscribe page not viewing correctly.

I am using Wordpress 3.5.2.

Please use m y email to reach me gbsaonline@gmail.com. I tried to check the box below but it won't check.

Thanks,
Barry Diamond

PS I tried to send this from the support dashboard on the site, but it would not send.