ATCSA 2025 | Registration Form

REGISTRATION FORM

CATEGORY *

FOREIGN DELEGATE PRC NOT APPLICABLE

7-digit PRC NUMBER *

PRC EXPIRY DATE *

SALUTATION *

LAST NAME *

FIRST NAME *

MIDDLE INITIAL

SUFFIX

PRINT NAME AS TO APPEAR ON CERTIFICATE *

EMAIL ADDRESS*

COUNTRY *

MOBILE NUMBER *

BUSINESS ADDRESS *

ORGANIZATION *

DIETARY REQ

VEGETARIAN

NO PORK

I would require an invitation letter for a visa application

Yes

GALA DINNER

I will attend the Gala Dinner on 22 Nov 2025 / Sat

ALLERGIES

PRE-CONGRESS WORKSHOP

19 November 2025 WORKSHOPS	LOCAL DELEGATES PARTNER SOCIETIES	FOREIGN DELEGATES	AVAILABLE SLOTS
THORACIC SURGERY 1: VATS for Inflammatory Lung Disease: Live Surgery Demo and Masterclass Lung Center of the Philippines, Quezon Avenue, Quezon City WHOLE DAY SESSION: 07:30 - 18:00	200 USD	250 USD	1
VASCULAR SURGERY 1: Chronic Venous Insufficiency - RF Ablation & Cyanoacrylate Quirino Memorial Medical Center, Quezon City WHOLE DAY SESSION: 07:30 - 16:00	80 USD	100 USD	6

20 November 2025 WORKSHOPS	LOCAL DELEGATES PARTNER SOCIETIES	FOREIGN DELEGATES	AVAILABLE SLOTS
CARDIAC SURGERY 1: Mastering OPCAB through Simulation Training Room A-1, 5th Floor, Medical Arts Building, Philippine Heart Center, East Avenue, Quezon City MORNING SESSION: 08:00 - 12:00	75 USD	125 USD	8
CARDIAC SURGERY 2: Aortic Root Enlargement Workshop Skills Laboratory, 5th Floor, Medical Arts Building, Philippine Heart Center, East Avenue, Quezon City AFTERNOON SESSION: 12:00 - 17:00	150 USD	175 USD	7
CARDIAC SURGERY 3: IABP: Fundamentals of Counterpulsation Therapy Workshop Training Room A-2, 5th Floor, Medical Arts Building, Philippine Heart Center, East Avenue, Quezon City AFTERNOON SESSION: 13:00 - 17:00	75 USD	125 USD	9

REGISTRATION AMOUNT

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By registering for this event, I hereby confirm that I authorize Association of Thoracic and Cardiovascular Surgeons of Asia to collect, process and store the information asked for in the registration form.
The information collected will be used for legitimate business purposes – as proof of my attendance and participation in the event. It will also be used for CPD compliance as well as any other requirements which might be needed in relation to my participation in these events. I give my consent for my NAME and EMAIL ADDRESS to be shared with the industry partners only for attendance purposes in the industry sessions.

For assistance regarding your registration, please contact technical support at
Text/Call: +639384414225 | Viber: +639384414225 | email: atcsamanila2025reg@gmail.com