ATCSA 2026

Delegate Profile

Primary EmailID ^*

louis.samuels@jefferson.edu

Secondary email

Name Title ^*

Prof.

First Name ^*

Louis

Last Name ^*

Samuels

Gender

Male

Year of birth

1961

Institute/ Organisation ^*

Thomas Jefferson University/Jefferson Einstein Philadelphia

Designation ^*

Department of Cardiac Surgery

Address ^*

5501 Old York Road Klein Building— Suite 401

City ^*

Philadelphia

Zipcode/Pincode ^*

19141

State

Pennsylvania

Country ^*

United States

Mobile No ^*

1 2675154067

For obtaining Permissions for Conference Visa process from Ministry in India, we need to have the following information from all International delegates and faculty:

Name (as per passport)
Nationality
Date of Birth
Country of birth
Passport Number
Expiry Date of Passport
Passport issuing authority / place of issue.
Credentials/ Professional Details (Organisation name with Designation and address)
Address – As per passport / communication

Full Name (As per passport) *

Nationality *

Date of Birth*

Country of birth *

Passport Number *

Issue Date of Passport *

Expiry Date of Passport *

Place of Issue *

Credentials/ Professional details (Organization name with Designation & address) *

Address in country of residence *

Please upload your passport *
(Front and back side of passport - pdf file)

Please upload your CV (Detailed Curriculum Vitae with picture - pdf file)
(Only required for Delegates from China, Hong Kong, Taiwan, Japan, Mongolia and South Korea)