Part-Time Instructor
Employment Forms

Welcome to Dixie State University. The following documents are for those that are new to DSU, or if you are returning after a 12 month break.

Part-Time Instructor Checklist

Please use the Part-Time Instructor Checklist as a guide to ensure all employment forms are submitted to the Human Resources office. The department administrative assistant, or secretary may complete the form for Part-Time Instructor member.

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New P/T Instructor

Online Application for New Part-Time Instructor

All new Part-Time Instructor employees are to complete the application, detailing general information.

Online Application

W-4 Tax Withholding

W-4 form is used to set your tax marital status and allowances for federal withholding tax. Fill out numbers 1-7. Sign on the Employees signature line and date.

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Direct Deposit

Use the DSU Direct Deposit Form to participate in the direct deposit program. Deposits may be made to any bank or credit union checking or savings account. See DSU Policy 342 for additional information.

Bring a void check, or a deposit authorization from the bank.

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Background Form

To be completed for all new and returning Part-Time Instructor members.

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I-9 Section 1 By College

New and returning Part-Time Instructor members are to complete the online Employment Eligibility Verification (I-9) on or before your first day of employment. Once this is complete, employees take their forms of ID to the Human Resources office to complete Section 2. The I-9 form is used for verifying the identity and employment authorization of individuals hired for employment in the United States. BOTH employees and employers must complete the form.

New employees must bring their original unexpired acceptable documents into the Human Resources office.  Any expired documents, copies, faxes, digital copies, or unacceptable documents cannot be accepted and will delay the process of payments.

View Accepted Documents


of Acknow-ledgement

Policy 150 Addenda A: Minors and Vulnerable Adults on Campus and Policy 302 Addenda C: Professional Boundaries in Relationships. Employees are to review and submit the completed documents to the Human Resources office.

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Safe Colleges Training

The safety of our students, staff, and faculty is of the utmost importance. That’s why we’re pleased to offer the SafeColleges online training system for our employees.New and Returning employees are required to complete assigned SafeColleges training.

If the training is not completed 60 days after the hire date, a letter of non-compliance will be placed in the employee’s file.

Online Training

Health Insurance

As part of the Affordable Care Act, employers are required to provide a notice of the availability of a Health Insurance Marketplace Coverage.

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F/T Staff To Request
Part-Time Instructor

Overload Assignment Authorization

This form is to be completed for full time exempt staff employees to request to teach part time.

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Office of Human Resources


Phone: 435-652-7520

Fax: 435-656-4001

Office: North Burns
225 S. University Avenue
St. George, UT 84770

Greg Esplin

Human Resources Coordinator


Phone: 435-652-7503

Office: Burns North 145