Adjunct Instructor Employment Forms Contact Greg Esplin, HR Coordinator, at 435-652-7503 for any questions.
Department Responsibilities (1 Part)
New Adjunct Responsibilities (7-8 Parts)
Part 1: Online Part-Time DSU Application. To be complete for all part time positions.
Part 2: Background Form To be completed for all new and returning adjunct members.
Part 3: DSU Direct Deposit Form (pdf) Used to set up direct deposit of earnings into employee’s financial institution.
Part 4: 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.
Part 5: Statement of Acknowledgement for Individuals Working with Minors at Dixie State University.
Part 6: W-4 Tax Withholding Form (pdf) Used to set your tax marital status and allowances for federal withholding tax.
Part 7: 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.
Form used for Full Time Staff Member Request to Adjunct: