Is completion mandatory?

Responses should be voluntary unless a specific program or legal obligation requires collection. Employers should avoid making demographic fields mandatory to reduce legal risk and encourage participation.

How is the data used?

Organizations must state the purpose in plain language—such as workforce analytics or supplier diversity reporting—and disclose who has access to raw responses and how aggregation or anonymization will occur.

Can I submit anonymously?

If the program permits anonymous submissions, provide that option and adjust data linkage methods. Anonymous responses cannot be tied to employment actions or benefits.

How do I correct a submitted response?

Provide a documented correction process and a contact for requests. For digital submissions, allow respondents to update entries within a defined window and keep an audit trail of changes.

Is an eSignature acceptable?

Yes. Electronic signatures that meet ESIGN/UETA standards demonstrate intent, attribution, and retention, making them valid for consent and acknowledgement where permitted by law.

How is the data secured?

Use platforms with encryption in transit and at rest, role‑based access controls, and audit logs. For health‑related data ensure HIPAA controls and a BAA are in place.

Electronic Signature
Templates
Miscellaneous
Diversity Inclusion Form

Diversity Inclusion Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

DIVERSITY & INCLUSION SERVICES AGREEMENT

This Diversity & Inclusion Services Agreement (the Agreement) is entered into as of by and between Client Name: and Provider Name: .

RECITALS (WHEREAS)

WHEREAS, Client seeks to engage Provider to deliver diversity, equity, inclusion and belonging consulting services, training, assessments and related deliverables as set forth in this Agreement; and

WHEREAS, Provider represents that it has the expertise, personnel and resources necessary to perform the services and agrees to provide such services on the terms and conditions set forth herein.

WHEREAS, the parties wish to document the scope, payment, confidentiality and related terms governing their engagement.

SCOPE OF WORK

Provider will provide the services described below. Provider shall exercise the degree of skill and care ordinarily exercised by professionals performing comparable services. Specific deliverables, timelines and performance standards will be set forth in the Scope of Work.

Detailed Scope of Work

DIVERSITY INCLUSION FORM (VOLUNTARY)

The following voluntary demographic information is collected to assist Client in measuring and improving diversity and inclusion efforts. Completion is voluntary, responses are confidential consistent with the Confidentiality clause below, and selections will not affect hiring, engagement, or contractual decisions unless otherwise stated.

Preferred Name Pronouns Job Title / Role Race / Ethnicity (select all that apply)

Asian Black or African American Hispanic or Latino American Indian or Alaska Native Native Hawaiian or Other Pacific Islander White Other (please specify):

Gender Identity (select all that apply)

Female Male Non-binary/Third gender Prefer not to say Other:

Veteran Status

Veteran Not a veteran Prefer not to disclose

Disability Status

Individual with a disability Not an individual with a disability Prefer not to disclose

Accommodation Needs Voluntary Disclosure Consent

I acknowledge that the information provided is voluntary, accurate to the best of my knowledge, and may be used by Client for legitimate business purposes such as reporting, training evaluation, and improving inclusion initiatives. I understand that my responses will be treated in accordance with the Confidentiality provisions of this Agreement.

PAYMENT TERMS

Client agrees to pay Provider the fees and expenses set forth below. All fees are exclusive of applicable taxes unless otherwise stated.

Total Fee Payment Schedule / Milestones Late Payment Fee

All undisputed invoices shall be payable within the number of days specified in the Payment Schedule. Overdue amounts shall bear interest as set forth in the Late Payment Fee field and Client shall be responsible for all reasonable collection costs and attorneys' fees incurred by Provider in collecting past due amounts.

TERM AND TERMINATION

This Agreement commences on the Start Date and continues until the End Date unless earlier terminated in accordance with this section.

Start Date End Date Notice Period for Termination

Either party may terminate this Agreement for material breach by the other party if the breaching party fails to cure such breach within the Notice Period after receiving written notice specifying the breach. Provider may suspend performance for nonpayment consistent with the Payment Terms, provided Provider has given prior written notice of intent to suspend.

CONFIDENTIALITY

For purposes of this Agreement, Confidential Information means non-public information disclosed by one party (Discloser) to the other (Recipient) that is designated as confidential or that, under the circumstances, ought reasonably to be treated as confidential. Confidential Information includes business plans, training materials, demographic data, and any personal data provided through the Diversity Inclusion Form.

Recipient shall: (a) protect Confidential Information with at least the same degree of care it uses to protect its own confidential information, but no less than reasonable care; (b) use Confidential Information solely to perform its obligations under this Agreement; and (c) not disclose Confidential Information to any third party except to employees, contractors, or advisors with a need to know who are bound by confidentiality obligations at least as protective as those herein.

Confidential Information does not include information that: (i) is or becomes generally available to the public other than through the Recipient's breach; (ii) was in Recipient's lawful possession prior to receipt; (iii) is rightfully received from a third party without restriction; or (iv) is independently developed by Recipient without use of Confidential Information. If Recipient is compelled by law to disclose Confidential Information, Recipient shall provide Discloser prompt notice to allow Discloser to seek protective relief and shall only disclose that portion legally required.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflicts of law principles.

ENTIRE AGREEMENT

This Agreement (including any attached Scope of Work and the Diversity Inclusion Form) constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings and agreements, whether written or oral. Any amendment must be in writing and signed by authorized representatives of both parties.

MISCELLANEOUS

Neither party shall assign this Agreement without the prior written consent of the other, except to a successor to substantially all of its business. The failure to exercise any right shall not constitute a waiver. If any provision is held invalid, the remainder shall remain in effect.

Client:

By:

Date:

Provider:

By:

Date:

What the Diversity Inclusion Form Is and why organizations use it

A Diversity Inclusion Form is a voluntary questionnaire used to collect self‑reported demographic and affiliation information from employees, applicants, vendors, or program participants. Typical fields include race, ethnicity, gender identity, veteran status, disability status, and optional narrative responses about inclusion needs. Organizations use the form to measure workforce composition, track diversity goals, meet supplier‑diversity reporting requirements, and assess program access. Responses are usually aggregated and anonymized for analysis to reduce the risk of individual identification while supporting equal‑opportunity, affirmative‑action, and vendor‑diversity initiatives.

How the form supports compliance and informed decision making

A Diversity Inclusion Form gives organizations structured data to monitor representation, design equitable policies, and comply with voluntary reporting obligations. When collected appropriately, the data informs recruitment, retention, and supplier‑diversity strategies while protecting individual privacy.

Who typically completes or issues this form

Diversity Inclusion Forms are used across employment and vendor lifecycles by HR teams, procurement, diversity officers, and program administrators.

HR and talent acquisition teams tracking applicant and employee demographics for internal metrics
Procurement and supplier diversity programs collecting vendor demographic classifications
Diversity, equity, and inclusion (DEI) officers running voluntary surveys and program assessments

Use internal policies to define who may request responses and how the data will be used, retained, and reported.

Core sections to include in a professional Diversity Inclusion Form

A clear structure improves response rates and legal defensibility. Include a consent header, demographic selection fields, voluntary self‑identification options, a privacy and data‑use statement, optional narrative questions, and a signature/acknowledgement area that records consent to collect and store the data.

Consent statement

Explain voluntary nature, purpose of collection, and how data will be used and aggregated.

Demographic selections

Standardized checkboxes for race, ethnicity, gender identity, veteran status, and disability.

Voluntary text fields

Optional narrative fields for self‑description or accommodation requests.

Privacy notice

Describe storage, access controls, retention period, and contact for questions.

Acknowledgement

A dated acknowledgement or e‑signature capturing consent and submission date.

Aggregation plan

Note how responses will be anonymized or grouped before reporting.

Step-by-step: completing and submitting the form

Follow these steps to complete a Diversity Inclusion Form accurately and consistently.

01

Review purpose: Read the consent and privacy statement before starting.
02

Complete demographics: Select standardized options; use 'Prefer not to answer' if desired.
03

Add notes: Provide optional narrative information or accommodation requests.
04

Sign and submit: Provide dated consent using permitted signature method and submit.

How digital collection and routing typically works

A secure e‑form workflow reduces manual handling and ensures an auditable trail from submission to reporting.

Form creation: Create a template with required and optional fields.
Consent capture: Present privacy notice and obtain affirmative consent.
Secure submission: Encrypt data in transit and at rest.
Aggregate reporting: Export anonymized summaries for analysis.

Recommended online workflow settings for the form

Configure field validation, access controls, and retention settings when publishing the form in an eSignature or form platform.

Field	Configuration
Required fields	Only require consent acknowledgment; demographic questions should remain optional.
Authentication	Use email verification or single sign‑on for internal users.
Encryption	Enable TLS in transit and AES‑256 at rest.
Retention flag	Apply automatic archival after retention period ends.

Technical considerations for digital collection and signing

Choose a platform that enforces authentication, audit trails, and configurable retention policies.

Authentication: Email, SSO, or multi‑factor options
Audit trail: Capture timestamps and IP addresses
File formats: Exportable as PDF or CSV

Maintain role‑based access and encryption; document platform settings and who may view raw responses.

Timelines and expected processing for submissions

Establish a clear schedule for collection windows, analysis, and reporting to stakeholders while honoring privacy and retention limits.

Collection window:

Set a start and end date for voluntary submissions, typically 2–8 weeks.

Acknowledgement timing:

Provide immediate receipt on submit, including the submission date.

Aggregation schedule:

Run reporting quarterly or annually as required by policy.

Retention review:

Review stored responses at predefined retention milestones.

Access requests:

Respond to data access or deletion requests per applicable privacy law timelines.

Key milestones in a typical diversity data cycle

Track milestones from announcement to reporting so stakeholders know when to expect results and audits.

01

Program announcement

Stakeholders informed and form link distributed.

02

Submission deadline

Last day to submit individual responses.

03

Data validation

Quality review and deduplication of responses.

04

Reporting and review

Publish aggregated metrics to authorized audiences.

Common mistakes organizations make when using this form

Making demographic questions mandatory, which reduces response rates and may raise legal concerns about voluntariness
Failing to provide a clear privacy notice explaining purpose, access, retention, and the right to decline
Storing raw personally identifiable responses without adequate access controls or anonymization for reporting
Using inconsistent categories over time, which prevents reliable trend analysis and benchmarking

Potential legal and operational risks of incorrect handling

Discrimination claims: Improper use can support discrimination allegations

Privacy violations: Failure to secure data may trigger state privacy enforcement

Regulatory fines: State consumer privacy laws can impose penalties

Reputational harm: Data misuse undermines trust and participation

Data breach costs: Incident response and notice expenses may follow

Inaccurate reporting: Flawed data can lead to poor policy choices

Typical eSignature vendor pricing and capabilities for form collection

Cost and feature needs vary by volume, security requirements, and integrations. signNow is listed first for direct comparison; verify plans directly with each vendor before purchasing.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7‑day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes (Premium)	Yes	Yes	Yes	Limited
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes (BAA)	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Security and compliance controls to require for the form

Encryption: TLS 1.2/1.3 in transit; AES‑256 at rest

HIPAA: HIPAA compliant when BAA executed

ESIGN / UETA: Meets ESIGN and UETA e‑signature standards

SOC 2: SOC 2 Type II available

ISO 27001: Certified for information security

21 CFR Part 11: Available controls for regulated environments

Frequently asked questions about the Diversity Inclusion Form

Answers to common questions about voluntariness, privacy, eSigning, and corrections when filling out the form.

Need help? Contact support

Is completion mandatory?
Responses should be voluntary unless a specific program or legal obligation requires collection. Employers should avoid making demographic fields mandatory to reduce legal risk and encourage participation.
How is the data used?
Organizations must state the purpose in plain language—such as workforce analytics or supplier diversity reporting—and disclose who has access to raw responses and how aggregation or anonymization will occur.
Can I submit anonymously?
If the program permits anonymous submissions, provide that option and adjust data linkage methods. Anonymous responses cannot be tied to employment actions or benefits.
How do I correct a submitted response?
Provide a documented correction process and a contact for requests. For digital submissions, allow respondents to update entries within a defined window and keep an audit trail of changes.
Is an eSignature acceptable?
Yes. Electronic signatures that meet ESIGN/UETA standards demonstrate intent, attribution, and retention, making them valid for consent and acknowledgement where permitted by law.
How is the data secured?
Use platforms with encryption in transit and at rest, role‑based access controls, and audit logs. For health‑related data ensure HIPAA controls and a BAA are in place.

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