Uber Eats & Canteen: Meals That Matter

Personal Details

First Name

Last Name

Email Address

Date of Birth

Mobile Number

This is where your voucher will be sent

Select your State/Territory

Are you under the age of 18?

YesNo

I, as the parent/guardian, provide consent for my child to apply for this initiative.

Yes

Parent/Guardian Name

Date

Connection to Youth Cancer Services (YCS)

Where are you currently receiving treatment?

Who is your YCS primary contact?

Have you discussed this application with your social worker?

YesNo

Awareness of Canteen Services

How confident are you in accessing Canteen services?

Canteen provides free counselling, peer support, and resources for young people 12-25 years impacted by cancer. How likely are you to use these support services?

Consent and Declaration

Please tick each box to confirm

I confirm that the information provided is true and accurate and consent to Canteen calling me to verify my application

I consent to Canteen sharing my information with Uber for the purpose of providing the voucher.

I consent to receive information about Canteen services.

I consent to be contacted by Canteen to provide feedback on this program.

Not at all confident	Slightly confident
Moderately confident	Very confident
Extremely confident

Not at all confident	Unlikely
Neutral	Likely
Extremely likely

Canteen x Uber Eats Landing page

Meals That Matter - Apply Now!

Who can apply?

Key dates:

Uber Eats Relief: Cancer Support

Uber Eats/Groceries Voucher ($500) for young people newly diagnosed with cancer

Acknowledgement of Country

Diversity and Inclusion

Digital Mental Health Standards