What is required to complete the form

Provide full legal name, taxpayer identification, contact details, required supporting documents listed on the form, and an authorized signature. Missing information is the most common reason for rejection.

Can I sign electronically

Electronic signatures are generally valid under U.S. law through ESIGN and UETA for most transactions. Confirm whether your organization or the receiving authority requires wet signatures, notarization, or RON for specific items.

What supporting documents are typical

Common attachments include copies of licenses, certificates, tax forms, proof of insurance, and any documentation cited in the form. Submit legible, dated PDFs to avoid delays.

How long does processing usually take

Acknowledgment typically occurs within 1 to 2 business days; verification and final decision timelines vary from one week to several weeks based on volume and complexity.

How do I correct an error after submission

Contact the intake administrator and, if allowed, submit a corrected form version. Some organizations require a written amendment or notarized correction for material changes.

How can inclusion be revoked or appealed

Procedures vary; most organizations maintain an appeals process or administrative review. Requesters should review the organization’s policy for revocation, appeals timelines, and any required documentation.

Electronic Signature
Templates
Miscellaneous
Inclusion Request Form

Inclusion Request Form

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

Inclusion Request Form

Date of Request:

Parties and Contact Information

Requesting Party Name Requesting Party Address Primary Contact (Requesting Party) Included Party / Candidate for Inclusion

Recitals

WHEREAS, Requesting Party seeks to include Included Party as an approved provider, vendor, consultant, or participant in the Requesting Party's programs, projects, supplier list, or other inclusion initiatives described herein;

WHEREAS, Included Party represents that it possesses the necessary qualifications, licenses, facilities, personnel, and authorizations to perform the scope of work and to comply with applicable standards, policies, and laws; and

WHEREAS, the parties desire to set forth the terms and conditions by which Included Party will be considered and accepted for inclusion and to memorialize payment, confidentiality, term, and other operative terms.

Scope of Work

Included Party will perform the services, deliverables, and obligations described below in accordance with the standards and timelines agreed by the parties:

Payment Terms

Compensation: Requesting Party shall pay Included Party the total amount set forth below for the services described in the Scope of Work. Payment shall be conditioned on submission of proper invoices and satisfaction of acceptance criteria specified herein.

Total Contract Amount Payment Schedule / Milestones

Late Payment: Any undisputed amount not paid when due shall accrue interest at the rate indicated below, calculated monthly on the outstanding balance until paid in full.

Late Fee / Interest Invoicing Instructions

Term and Termination

This inclusion arrangement shall commence on the date below and shall continue until the end date below unless earlier terminated in accordance with this section.

Start Date:

End Date:

Either party may terminate this inclusion by providing written notice to the other party as specified below. Termination will not relieve either party of obligations accrued prior to the effective date of termination.

Notice Period for Termination (days)

Confidentiality

Each party acknowledges that, in the course of performance or evaluation of inclusion, it may receive or have access to confidential or proprietary information of the other party ("Confidential Information"). Confidential Information shall include nonpublic business, financial, technical, operational, customer, and pricing information. Each party shall:

(a) hold Confidential Information in strict confidence and use at least the same degree of care it uses to protect its own confidential information but no less than reasonable care; (b) not disclose Confidential Information to any third party except as permitted below; and (c) use Confidential Information solely for the purpose of evaluating or performing the Scope of Work under this inclusion request.

Permitted disclosures: A party may disclose Confidential Information to its employees, contractors, or advisors who have a need to know and who are bound by confidentiality obligations no less protective than those herein, and as required by law or court order provided the disclosing party gives prompt notice to the other party to allow intervention or protective measures.

Representations, Warranties and Indemnity

Included Party represents and warrants that it has the full power and authority to enter into this agreement, that performance will conform to applicable laws and industry standards, and that its personnel are appropriately qualified. Each party shall indemnify and hold harmless the other party from third-party claims arising from breaches of this agreement, gross negligence, or willful misconduct, subject to any limitations set out in a separate written agreement between the parties.

Governing Law

This Inclusion Request Form and any resulting inclusion relationship shall be governed by and construed in accordance with the laws of the jurisdiction specified below, without regard to conflict of law principles.

Governing Jurisdiction

Entire Agreement; Amendments

This document, together with any attachments or documents expressly incorporated by reference and any signed addenda, constitutes the entire agreement between the parties with respect to inclusion and supersedes all prior discussions, proposals, and understandings. Any amendment or modification of this agreement must be made in writing and signed by authorized representatives of both parties.

Acknowledgment

By signing below, each party acknowledges that it has read and understands this Inclusion Request Form, that it has the authority to bind the party on whose behalf it signs, and that it agrees to the terms set forth herein.

Requesting Party - Print Name:

Included Party - Print Name:

By:

Date:

What an Inclusion Request Form Is and when it’s used

An Inclusion Request Form is a formal written request used to ask an organization, program, vendor list, or directory to add an individual, supplier, or entity to an established roster. The form typically collects identifying details, eligibility criteria, documentation that demonstrates qualifications or status, and contact information. Organizations use it to standardize intake, verify required credentials, and record consent to terms or background checks. While formats vary, an inclusion request serves as the official record that initiates review, approval workflow, and any follow-on onboarding or compliance checks.

Why a clear Inclusion Request Form matters

A well-structured form speeds review, reduces follow-up, and creates an auditable record of submission and consent. It protects both the requester and the receiving organization by documenting eligibility, required supporting documents, and any representations made at the time of request.

Who typically completes and reviews these forms

Organizations and individuals complete inclusion requests when adding people or entities to lists, programs, or supplier rosters.

Prospective vendors and contractors submitting credentials and certifications for procurement or approved vendor lists.
HR or diversity managers requesting employees be listed in internal programs or external catalogs.
Program applicants seeking enrollment in grants, supplier diversity directories, or partner networks.

Reviewers usually include procurement, compliance, HR, or program administrators who confirm eligibility and attach approvals to the intake record.

Essential sections to include in a professional Inclusion Request Form

Design the form to collect core identity data, eligibility evidence, authorizations, and processing metadata so reviewers can evaluate requests consistently and defensibly.

Requester ID

Unique identifier or applicant reference used to link the submission to internal systems and reduce duplicate reviews.

Contact Details

Complete mailing address, email, and phone number for notifications, escalation, and any required verification or notarization workflows.

Eligibility Criteria

Clear checklist or drop-down options showing the specific requirements the applicant asserts they meet, such as certifications, licenses, or diversity status.

Supporting Documents

Designated upload fields for attachments like certificates, licenses, tax forms, W-9, or other documentary proof required to establish inclusion.

Authorizations

Consent statements for background checks, data sharing, or verification plus signature and date fields to document legal assent.

Administrative Fields

Internal use fields such as intake date, reviewer, status, comments, and an audit trail reference for final disposition.

Required information elements at a glance

Legal name: Full entity or person name

Tax ID: EIN or SSN/TIN as applicable

Primary contact: Email and direct phone number

Mailing address: Street, city, state, ZIP

Supporting docs: List of required attachments

Signature date: MM/DD/YYYY format

Step-by-step: completing and submitting an Inclusion Request

Follow these sequential steps to prepare a complete request and reduce back-and-forth with reviewers.

01

Gather documents: Collect IDs, licenses, and certifications before starting to attach files.
02

Complete fields: Enter all required fields carefully using the formats described above.
03

Authorize and sign: Provide signature, printed name, and date in designated fields.
04

Submit and track: Upload files, submit, and retain confirmation or reference number for follow-up.

Where your submission goes and what happens next

After you submit, the form enters an intake workflow for verification, review, and final disposition. Typical checkpoints are listed here.

Intake: System assigns reference and logs submission time.
Verification: Staff confirm identity, licensing, and required supporting documents.
Review: Appropriate committee or approver evaluates eligibility.
Decision: Final status recorded and notification issued to requester.

Sharing and signing options for digital submissions

Inclusion Request Forms can be shared and signed electronically using secure eSignature or submitted as scanned signed copies.

Email submission: Attach completed PDF and necessary documents
eSignature platform: Use a compliant vendor to capture signature
In-person signing: Provide wet signature if required by policy

Choose a secure method that meets your organization’s authentication, retention, and privacy requirements and documents the chain of custody.

Typical online customization settings for intake workflows

Configure fields and routing so submissions automatically go to the right reviewers and triggers enforce completeness checks.

Field	Configuration
Required fields	Mark legal name, TIN, signature as mandatory
Conditional routing	Route to compliance when high-risk flags selected
Reviewer roles	Assign procurement, legal, and program reviewers
Notifications	Email alerts on submission and decision

Typical timelines and processing expectations

Processing times vary by organization and volume; include defined SLAs on the form or intake portal to set expectations.

Acknowledgment timeframe:

Usually within 2 business days of receipt

Initial verification:

Often completed in 5 to 10 business days

Full review time:

Can range from 2 to 6 weeks depending on complexity

Expedited requests:

May be granted with documented business justification

Appeal or resubmission:

Timelines should specify response period for applicants

Common mistakes that delay inclusion requests

Incomplete attachments or poor-quality scans that prevent verification of credentials and require resubmission.
Mismatched names or tax IDs that trigger identity checks or tax withholding requirements and prolong processing.
Missing signature authority details when an agent signs on behalf of an entity, causing requests for proof of delegation.
Incorrect file formats or filenames that fail automated ingestion and require manual handling by reviewers.

Risks and potential penalties of inaccurate submissions

Contract risk: Inaccurate data may void agreements

Tax consequences: Incorrect TIN can trigger backup withholding

Regulatory fines: Noncompliance may incur industry penalties

Reputational harm: False claims can harm future eligibility

Delayed payment: Incomplete forms can postpone invoices

Record rejection: Applications may be rejected without appeal

Comparing eSignature options for submitting Inclusion Request Forms

Choose a platform that meets your compliance, volume, and pricing needs. signNow is listed first for comparison clarity against other common vendors.

	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 vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Yes	Yes	Yes	Yes
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Frequently asked questions about Inclusion Request Forms

Answers to common questions about completing, signing, and correcting Inclusion Request Forms to reduce processing delays and compliance issues.

Need help? Contact support

What is required to complete the form
Provide full legal name, taxpayer identification, contact details, required supporting documents listed on the form, and an authorized signature. Missing information is the most common reason for rejection.
Can I sign electronically
Electronic signatures are generally valid under U.S. law through ESIGN and UETA for most transactions. Confirm whether your organization or the receiving authority requires wet signatures, notarization, or RON for specific items.
What supporting documents are typical
Common attachments include copies of licenses, certificates, tax forms, proof of insurance, and any documentation cited in the form. Submit legible, dated PDFs to avoid delays.
How long does processing usually take
Acknowledgment typically occurs within 1 to 2 business days; verification and final decision timelines vary from one week to several weeks based on volume and complexity.
How do I correct an error after submission
Contact the intake administrator and, if allowed, submit a corrected form version. Some organizations require a written amendment or notarized correction for material changes.
How can inclusion be revoked or appealed
Procedures vary; most organizations maintain an appeals process or administrative review. Requesters should review the organization’s policy for revocation, appeals timelines, and any required documentation.

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