Adjunct Instructor Employment Forms
Contact Greg Esplin, HR Coordinator, at 435-652-7503 for any questions.
- Adjunct Checklist (pdf) The department secretary completes the form for adjunct member.
New Adjunct Responsibilities
- Online Part-Time DSU Application To be complete for all part time positions.
- Background Form To be completed for all new and returning adjunct members.
- DSU Direct Deposit Form (pdf) Used to set up direct deposit of earnings into employee’s financial institution.
- Health Insurance Marketplace Coverage (pdf) As part of the Affordable Care Act, employers are required to provide a notice of the availability of a Health Insurance Marketplace.
- Statement of Acknowledgement for Individuals Working with Minors at Dixie State University.
- W-4 Tax Withholding Form (pdf) Used to set your tax marital status and allowances for federal withholding tax.
- Employment Eligibility Verification form (I-9)Employees complete Section 1 of the I-9 form by clicking on the link below, based on the hiring department. Once this is complete, employees take their forms of ID to the department administrative assistant to complete Section 2 to be hired.
Full Time Staff Member Request to Adjunct Form:
- Overload Assignment Authorization Form (pdf) For staff employees request to teach part time.