HR Forms

Benefit Forms

Contact Michelle Cabana at 435-652-7523 or cabana@dixie.edu for questions.

FAMILY AND MEDICAL LEAVE ACT FORMS
FMLA DSU An application for FMLA DSU. FMLA DSU Application (pdf)
FMLA Medical (Employee) A certification pdf for FMLA Medical. FMLA Medical Certification (pdf)(for Employee)
FMLA Medical (Family Member) A certification pdf for FMLA Medical. FMLA Medical Certification (pdf)(for a Family Member)
OTHER FORMS
Grievance Form Contact Human Resources at 435-652-7520 for any questions. Grievance Form (pdf)
Notice of Written Warning Contact Human Resources at 435-652-7520 for any questions. Written Warning (pdf)
Veteran Preference Eligibility Notice Contact Human Resources at 435-652-7520 for any questions. Veteran Notice Form (pdf)
Volunteer Form Contact Josh Thayn, Director Event Service & Risk Management at 435-652-7855 for any questions. Volunteer Form (pdf)

DSU Tuition Waiver Program

For benefited University employees, including those retired, and their spouses and eligible dependents.

Other Helpful Links