Survey Form with a Dependent Dropdown Selector from a Spreadsheet and Save the Details to another Spreadsheet

I want to make a form which can display a dependent dropdown and then save the selected details to another spreadsheet.
Until now I have made a sheet on airtable with the following headers.

The row header names are:-

I have an excel sheet with the country list ,state list and the city list.
I want a way so that the user can select the state on basis of country and the city on the basis of state along with the date he wants to enter .

Can you please help me with this?