. Let’s get to know you!

Hi CanTeen, My full name is
and I’m a .

Please correctly fill out all input fields.

Next Question

Nice to meet you . Tell us a bit about yourself!

I’m a

of
decent.
I was born on
.

Please correctly fill out all input fields.

Next Question

Previous Question

CanTeen is for young people who are 13 years old or over.
We’d love to have you when you turn 13!
For now, we’d recommend you get in touch with The Child Cancer Foundation.

Previous Question

CanTeen is for people 13-24 years old.
But there are lots of other support options for adults.
For more info or to get in touch please email info@canteen.org.nz

Previous Question

Where do you live in New Zealand?

I live in
.
My nearest CanTeen branch is .

Please correctly fill out all input fields.

Next Question

Previous Question

What’s your current situation?

I’m currently .
My NHI number (if you know it) is .

Please correctly fill out all input fields.

Next Question

Previous Question

Tell us about your diagnosis.

In of
I was diagnosed with .
I currently receiving treatment.

Please correctly fill out all input fields.

Next Question

Previous Question

Do you have brothers or sisters?

I have brothers and sisters.

Please correctly fill out all input fields.

Next Question

Previous Question

Can you tell us more about your sibling?

My brother or sister

Please correctly fill out all input fields.

Next Question

Previous Question

Due to their age, are also eligible to join CanTeen.

Please correctly fill out all input fields.

Next Question

Previous Question

Because you’re under 18, we need to know it’s OK to contact you.

My parent or guardian says it’s for CanTeen to contact me.

Please correctly fill out all input fields.

Next Question

Previous Question

Oops. You’ll need permission from a parent or guardian. Please come back to this form when you’re ready.

Previous Question

Thanks . Is there anything else you’d like to tell us about yourself? For example, if you have any visual impairments or medical implants?

Please correctly fill out all input fields.

Next Question

Previous Question

Please let us know how we can get in touch with you.

My email address is . My phone number (including area code) is , and my postal address is, .

Please correctly fill out all input fields.

Next Question

Previous Question

How would you like us to contact you?

Please contact me by
.

Please correctly fill out all input fields.

Next Question

Previous Question

Who can we contact in case of an emergency?

The young persons emergency contact is their , whose name is . Their email address is email , and phone number (including area code) is .

Please correctly fill out all input fields.

Next Question

Previous Question

Who can we contact for in case of emergency?

's emergency contact is my , whose name is . Their email address is email , and phone number (including area code) is .

Please correctly fill out all input fields.

Next Question

Previous Question

Thanks . You’re all done, we’ll be in touch soon!

In the meantime, why not check out some stories from Canteeners, or learn more about how we can help.

What’s your family relationship with cancer?

I a brother or sister with cancer.

Please correctly fill out all input fields.

Next Question

Previous Question

Do you have other brothers or sisters?

I have brothers and sisters.

Please correctly fill out all input fields.

Next Question

Previous Question

Can you tell us more about your other sibling?

My other brother or sister

Please correctly fill out all input fields.

Next Question

Previous Question

We’re sorry for your loss. Please tell us a little about them.

My sibling, , was diagnosed with . They passed away in of .

Please correctly fill out all input fields.

Next Question

Previous Question

Tell us about your sibling living with, or who survived cancer.

My sibling, ,
was diagnosed with .
They currently receiving treatment.

Please correctly fill out all input fields.

Next Question

Previous Question

What’s your family relationship with cancer?

I a parent or guardian with cancer.

Please correctly fill out all input fields.

Next Question

Previous Question

We’re sorry for your loss. Please tell us a little about them.

, was diagnosed with . They passed away in of .

Please correctly fill out all input fields.

Next Question

Previous Question

Tell us about your parent living with, or who survived cancer.

My , was diagnosed with .
They currently receiving treatment.

Please correctly fill out all input fields.

Next Question

Previous Question

Nice to meet you . Who would you like to refer to CanTeen?

I’d like to refer .
They are

of decent,
born on
.

Please correctly fill out all input fields.

Next Question

Previous Question

Where does live in New Zealand?

lives in
.
Their nearest CanTeen branch is .

Please correctly fill out all input fields.

Next Question

Previous Question

What is 's current situation?

is currently .
Their NHI number (if you know it) is .

Please correctly fill out all input fields.

Next Question

Previous Question

Tell us about 's diagnosis.

In of was
diagnosed with .
They currently receiving treatment.

Please correctly fill out all input fields.

Next Question

Previous Question

Does have brothers or sisters?

has brothers and sisters.

Please correctly fill out all input fields.

Next Question

Previous Question

Can you tell us more about 's sibling (please fill in as much as you can)?

's brother or sister

Please correctly fill out all input fields.

Next Question

Previous Question

Because is under 18, we need to know it’s OK to contact them.

's parents or guardian says it’s for CanTeen to contact them.

Please correctly fill out all input fields.

Next Question

Previous Question

Thanks . Is there anything else you’d like to tell us about ? For example, if you have any visual impairments or medical implants?

Please correctly fill out all input fields.

Next Question

Previous Question

Please let us know how we can contact .

's email address is . Their phone number (including area code) is , and their postal address is .

Please correctly fill out all input fields.

Next Question

Previous Question

How would prefer to be contacted?

Please contact by
.

Please correctly fill out all input fields.

Next Question

Previous Question

Oops!

You current browser is out of date and might not be able to display the CanTeen site correctly. Please update your browser

Looking to sign yourself or someone else up to CanTeen?

Home
Get Involved
Volunteer
Bandanna Day Volunteer

Help out on the day

Next year CanTeen’s Bandanna Day is on Friday the 26th of March, 2021.

On this day CanTeen staff and volunteers are hitting the streets to raise funds and awareness for young people living with cancer. Sign up below to raise funds in your area and we’ll be in touch!

Bandanna Day Registration Of Interest

Name*
First Last
Address*
Street Address Address Line 2 Suburb City Postal Code Country
Phone*
Email*
Are you over 18 years old?*
- Yes
- No
In what city would you prefer to volunteer?*
Comments
Comments
This field is for validation purposes and should be left unchanged.

. Let’s get to know you!

Nice to meet you . Tell us a bit about yourself!

CanTeen is for young people who are 13 years old or over. We’d love to have you when you turn 13! For now, we’d recommend you get in touch with The Child Cancer Foundation.

CanTeen is for people 13-24 years old. But there are lots of other support options for adults. For more info or to get in touch please email info@canteen.org.nz

Where do you live in New Zealand?

What’s your current situation?

Tell us about your diagnosis.

Do you have brothers or sisters?

Can you tell us more about your sibling?

Due to their age, are also eligible to join CanTeen.

Because you’re under 18, we need to know it’s OK to contact you.

Oops. You’ll need permission from a parent or guardian. Please come back to this form when you’re ready.

Thanks . Is there anything else you’d like to tell us about yourself? For example, if you have any visual impairments or medical implants?

Please let us know how we can get in touch with you.

How would you like us to contact you?

Who can we contact in case of an emergency?

Who can we contact for in case of emergency?

Thanks . You’re all done, we’ll be in touch soon!

What’s your family relationship with cancer?

Do you have other brothers or sisters?

Can you tell us more about your other sibling?

We’re sorry for your loss. Please tell us a little about them.

Tell us about your sibling living with, or who survived cancer.

What’s your family relationship with cancer?

We’re sorry for your loss. Please tell us a little about them.

Tell us about your parent living with, or who survived cancer.

Nice to meet you . Who would you like to refer to CanTeen?

Where does live in New Zealand?

What is 's current situation?

Tell us about 's diagnosis.

Does have brothers or sisters?

Can you tell us more about 's sibling (please fill in as much as you can)?

Because is under 18, we need to know it’s OK to contact them.

Thanks . Is there anything else you’d like to tell us about ? For example, if you have any visual impairments or medical implants?

Please let us know how we can contact .

How would prefer to be contacted?

Oops!

Help out on the day

Bandanna Day Registration Of Interest

CanTeen is for young people who are 13 years old or over.
We’d love to have you when you turn 13!
For now, we’d recommend you get in touch with The Child Cancer Foundation.

CanTeen is for people 13-24 years old.
But there are lots of other support options for adults.
For more info or to get in touch please email info@canteen.org.nz