Mentorship & Career Counseling Application

If you are a student interested in a day of mentorship or career counseling, please fill out the form below.

Be sure to read the Mentor Program FAQ.

Please use a personal email address (Google, Yahoo, etc.) when contacting us instead of a university or company-based email address.
Please provide dates that are at least two weeks from the date of your application.


First name:
Last name:
Phone Number:
Address 1:
Address 2:
Year Graduated:
o Are you applying for a full day of mentorship or an hour-long career counseling session?
Please list five dates you would be available, in order of importance.
Please list six professional mentors, in order of importance. (View Mentors)
Please briefly describe your professional ambitions and/or interests.
The Harold E. Eisenberg Foundation
540 W. Frontage Rd., Suite 2210   Northfield, IL 60093