The error I see is:
You must specify a email_address value for the listSubscribe method
And looking at your email form - I only see a name field How are the people going to subscribe to your form if you don't give them the option to enter a mail address :P
Go to the module settings in the backend and also select the email field.
Cheers,
Daniel

Sorry, I did not know that the fields should be marked! :-) Thanks a million!

Don't forget to leave a review over here!
http://extensions.joomla.org/extensions/content-sharing/mailing-a-newsletter-bridges/21710

Thanks in advance!
Daniel