Required PHP freelancer for ManyChat subscription Form Creation job

I need just an HTML form with two fields.
1. Name
2. Email
what I need specifically is this saves both user inputs to manychat/mailchimp list. You may use their simple API or directly go in their dashboard .
for more info please let me know.

its a quick job who have done similar things in PHP . I am using Laravel and Bootstrap.

Skills & Expertise Required

PHP