ARForms is a premium wordpress form builder plugin with inbuilt support of multiple email marketing system integration facility. It has support of 7 autoresponder systems which are Aweber, mailchimp, getresponse, Icontact, Constant contact, Ebizac, GVO.
Demo: http://codecanyon.net/item/arforms-wordpress-form-builder-plugin/6023165
source http://www.codelist.cc/plugins/244039-arforms-v50-wordpress-form-builder-plugin.html