Take information from form

I need help.
People, as you can see in the video, a modal opens, and the modal has 2 inputs of text type and a button to send. I need you to fill in the form and when you click on the “Add” button, the first and last name will be shown on the previous screen that says 1º1º.
How can I do that?

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Video: https://drive.google.com/open?id=1o3uZXC8cqap10aZT6XJIEVTs6RDbUhZu
//home page

//form page