Dots Home & Life Assistants April 2026

To help you with your application, you should read the following before completing your form.

We do not accept Curricula Vitae (CV’s). Therefore, it is important that you fully complete each section of our application form, giving the information requested.

It is the responsibility of each candidate to ensure that all such information is provided. Candidates who fail to provide sufficient information on which a panel might determine their eligibility for the post will not be shortlisted.

We have an equal opportunity policy and endeavour to ensure that selection for jobs, training and promotion is carried out fairly and based on job related criteria. In order for us to properly assess your application, it is important that you complete the form as fully as possible, demonstrating how your skills/experience relate to those described in the advert and Person Specification. The panel may enhance the criteria in order to facilitate short-listing of the post. The panel will shortlist only on the basis of the information provided on your application form.

We also need to monitor the effectiveness of our policy. I would therefore ask you to complete the enclosed monitoring form and return with your completed application form.

The Equal Opportunities Monitoring form is regarded as part of your application and failure to complete and return it will result in disqualification.

If you have any disability which prevents you from completing the application process, please contact me to discuss what further assistance you require.

The successful candidate will be required to provide proof of documentary evidence of their eligibility to work in the United Kingdom. We are also committed to adhering to the Access NI Code of Practice in relation to requesting disclosure checks where appropriate and processing information in accordance with the code. I would like to thank you for the interest you have shown in this post and I look forward to receiving your application form.

Yours sincerely
Sarah McLaughlin

Executive Director for Health

Application for Employment
Thank you for your interest in Dots, Delivering Options through Tailored Solutions.

We look forward to receiving your completed application form and monitoring form.

PRIVATE AND CONFIDENTIAL

Position: Home and Life Assistant
Locations: Ballymena area (Main office Broughshane)
Hours of working: Casual

1. APPLICANT DETAILS
Name

ForenamesSurname
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Mobile Number
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
National Insurance
Reasonable Adjustments
Please provide details of any special arrangements/adjustments in relation to either communications or access requirements if invited to interview.
Do you hold a full, clean driving licence valid in the UK
This criterion may be wavered if a disability prohibits driving. In this case you must have access to a form of transport which allows you to fulfil the requirements of the job in full. If appropriate, please indicate how you would meet this requirement.
Do you need a work permit to work in the UK?
As required under legislation, we will require you to present documentary evidence to confirm your right to work.

2. APPLICANT EMPLOYMENT HISTORY – CURRENT
CURRENT EMPLOYMENT

Please include any previous experience (paid or unpaid), starting with the most recent first.
Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment From

MonthDayYear
Date
Employment To

MonthDayYear
Date
Position / Job Title
Notice Period
Reason for Leaving
Contact Name for Reference
Key Duties and Responsibilities
Please use this to also note any additional Information (any other relevant information you feel may be relevant)

PREVIOUS EMPLOYMENT - 1

Please include any previous experience (paid or unpaid), starting with the most recent first.
Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment From

MonthDayYear
Date
Employment To

MonthDayYear
Date
Position / Job Title
Reason for Leaving
Contact Name for Reference
Key Duties and Responsibilities
Please use this to also note any additional Information (any other relevant information you feel may be relevant)

PREVIOUS EMPLOYMENT - 2

Please include any previous experience (paid or unpaid), starting with the most recent first.
Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment From

MonthDayYear
Date
Employment To

MonthDayYear
Date
Position / Job Title
Reason for Leaving
Contact Name for Reference
Key Duties and Responsibilities
Please use this to also note any additional Information (any other relevant information you feel may be relevant)

3. SKILLS AND EXPERIENCE
Explain how you meet the criteria of Home and Life assistant as set out in the job description. Please use examples of your own experience.
Do you have any other specific skills or experience you feel you could bring to this role e.g, multi-tasking, organisational etc?
This role will be contracted for at least 16 hours per week. Hours will be scheduled flexibly and may vary from week to week. Are there any days/times you cannot work?
Additional Information: Please let us know if there is anything else that would be helpful for us to know?

4. REFEREES

Please give the details of two referees, who must not be related to you, who can speak to your experience and character.

Rows	Reference 1	Reference 2
Referee Name
Position
Company Name
Address
Email

5. DECLARATION
- I declare that all the foregoing statements are true, complete and accurate.
- I understand that if I give wrong information or leave out important information I could be dismissed if I take up this job.
- I understand that to take up this job I must have satisfactory references, and ACCESS NI check (if applicable).
- I understand that I may be asked to show some formal identification and evidence of qualifications if required.
- I confirm that as far as I know there are no medical reasons which would stop me from carrying out the duties of this job.
- I agree to you making any necessary enquiries during the recruitment and selection process I understand that canvassing will disqualify me from the selection process for this job.
Signature
Date

MonthDayYear
Date
Should be Empty:

Application for Employment

1. APPLICANT DETAILS

2. APPLICANT EMPLOYMENT HISTORY – CURRENT

CURRENT EMPLOYMENT

PREVIOUS EMPLOYMENT - 1

PREVIOUS EMPLOYMENT - 2

3. SKILLS AND EXPERIENCE

4. REFEREES

5. DECLARATION