Bring form data into a new form

In the builder, on a specific form I selected "Custom Options Allow users to add new options. (?)" on a specific field. When in the live app, the user clicks the + sign to add a new record, I want to bring in data from the form onto the "Add new record" form.

So in my case, the user fills in address field - Country, then Province, then City, then Area. They then select the group they would like to join in their area. However, if there isn't a group, they can request a group in their area, but clicking the + (to add a new record). On the new record form, I want to bring in the data from the form they have already filled in, namely Country, Province, City and Area. These are to be non-editable, and upon form submission, a new record must be added to the "Groups" table which has fields: Name, Area, City, Province, Country.

Any suggestions how to do that?

PS. I use the code in the post below to then add the details into the Knack Address field so it can be used with maps: