acp south dakota chapter annual meeting

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SOUTH DAKOTA ACP SCIENTIFIC MEETING BEST WESTERN RAMKOTA September 12-14 Sioux Falls, SD 2012 Top: Falls Park ---- Right: David by Michaelangelo ---- Bottom: Ramkota

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SOUTH DAKOTA

ACP SCIENTIFIC MEETING

BEST WESTERN RAMKOTA

September 12-14Sioux Falls, SD

2012

Top: Falls Park ---- Right: David by Michaelangelo ---- Bottom: Ramkota

PROGRAM SCHEDULE:Wednesday,       4:00  -­‐  6:00  pm   South  Dakota  Council  Mee?ng

September  12     6:00  -­‐  8:00  pm   Governors’  Recep?on

*Council  Mee?ng  and  Governor’s  Recep?on  held  atTom  Braithwaite’s  home  -­‐-­‐-­‐  3705  S.  Lewis  Ave.,  Sioux  Falls,  SD    57103

Thursday,         7:00  am     Registra.on  Begins

September  13     7:25  am     Welcome  &  Introduc.ons

                -­‐Thomas  M.  Braithwaite,  Governor

        7:30  am     Morning  Session  Begins  -­‐  Mark  Lounsbery,  Moderator

        7:30  am     SEP  Module:    Hospice  &  Pallia.ve  Care,  Part  I

                -­‐LuAnn  Eidsness

        9:00  am     Update  on  Clostridium  Difficile  Infec.on  -­‐  Jorge  Gilbert

        10:00  am     BREAK

        10:30  am     Recogni.on  &  Management  of  Moderate  to  Severe  

                Persistent  Ashtma  -­‐  Michael  Pie.la

        11:10  am     College  Update  with  Q&A  -­‐  Thomas  G.  Tape,  ACP  Regent

        12:00  pm     LUNCH  PROVIDED

              Town  Hall  &  Business  Mee.ng  -­‐  Tom  Braithwaite

       

Washington Pavillion of Arts and Science

Thursday,       1:00  pm     AXernoon  Session  Begins  -­‐AnneYe  Bosworth,  Moderator

September  13     1:00  pm     Have  I  Got  A  Case  For  You!:    A  Cau.onary  Tale                   -­‐  Hesham  Elgouhari

        1:20  pm     Understanding  Medical  Controversies:    When  Evidence  and                   Theory  Collide  -­‐  Tom  Tape         2:20  pm     Have  I  Got  A  Case  For  You!:    Incidental  (or  Accidental)                   Finding  in  the  Immunosupressed  Popula.on  -­‐  Nathan  Miller

        2:40  pm     BREAK         3:10  pm     Management  of  HIV  -­‐  Donna  Sweet         4:10  pm     HIV/AIDS:    Common  Infec.ous  Complica.ons  -­‐  Jennifer  Hsu

        4:55  pm     Mee?ng  Adjourned        

              6:30  pm     Awards  Banquet                       Minnehaha  Country  Club                     3101  W.  22nd  St.

Falls Park

Friday,  September  14  

7:00  am     Advancement  to  Fellowship  Con?nental  Breakfast**

7:30  am     Morning  Session  Begins    -­‐  MaY  Jahraus,  Moderator

7:30  am     Hypertension  in  Two  Different  Worlds  

        -­‐  Chris.ne  Lankhort  

8:30  am     What’s  New  for  Women’s  Health:    The  Good,  The  Bad,

        The  Indifferent  -­‐  Donna  Sweet

9:30  am     Have  I  Got  A  Case  For  You!:    Stones,  Bones,  

        Abdominal  Groans,  Psychiatric  Moans  &  

        Diagnos.c  Unknowns  -­‐  Rick  Holm

9:50  am     BREAK  

10:20  am     Donald  Humphrey’s  Scholars’  Day  Winner:

        Coronary  to  Pulmonary  Artery  Fistulas  During

        Bacterial  Endocardi.s  Inves.ga.on:    A  Rare

        Incidental  Finding  -­‐  John  Kelly  Wachira

10:40  am     Resident  Poster  Session

        Pooja  Aggarwal,  Vanessa  Garcia-­‐Chen,           Mariko  Saso-­‐Hagiwara,  Dilpriya  Mangat,         Pavithra  PaYabiraman,  Troy  Rowekamp  and          

        Then  Tong      11:10  am     Have  I  Got  A  Case  For  You!:  Bringing  Down  Rocky

        -­‐  Jeremy  Cauwels

11:30  am     LUNCH  PROVIDED

      Can’t  Anyone  Here  Play  This  Game?:  Broken  Poli9cs,

        Broken  Health  Care,  Broken  Promises  -­‐  Bob  Doherty

   

St. Joseph’s Cathedral

Old Courthouse Museum

Pettigrew Museum

**Any  member  contempla?ng  applying  for  advancement  to  Fellowship  should  a_end,  as  well  as  current  Fellows  who  can  assist  those  seeking  Fellowship  by  ac?ng  as  seconders  to  their  applica?on.

Friday,  September  14  

1:30  pm     AXernoon  Session  Begins  -­‐  Marc  Aldrich,  Moderator

1:30  pm     Inpa.ent  and  Outpa.ent  Diabetes  Management:    An  Endocrinologist’s  

        Perspec.ve  -­‐  Brandon  Allard    

2:20  pm     BREAK

2:50  pm     SEP  Module:    Hospice  &  Pallia.ve  Care,  Part  II  -­‐  Joann  BenneY

4:20  pm     MEETING  ADJOURNED

MODERATORS:Marc  N.   Aldrich,  MD,  ACP  Member,   received  his  undergraduate  degree  at  Augustana  College  (Sioux  Falls)   and  his  medical  training   at   Sanford  USD  School  of  Medicine.     Following  medical  internship   with   the   Naval   Medical   Center   in   San   Diego   he   completed   Internal   Medicine  residency  at  the  University  of  Iowa  Hospitals  and  Clinics.    He  prac.ced  general  Internal  Medicine  with   Sanford   Health   from   1992   00   2004,   and   has  been   serving   Rapid   City   Regional  Health  System  as  a  hospitalist  since  2004.    He  and  his  wife,  Cynthia,  have  three  children.

Anne_e   Bosworth,  MD,  ACP  Member,   is  an   informa.cs  internal  medicine  physician   filled  with   the  passion  to  change  the  world  -­‐  one  life  at  a  .me.    She  is  the  founder  of   Independent  Medicine  Prof.  LLC,  and  Preven.ve  Health  Strategies,  a  non-­‐profit  organiza.on  focused  on  accessible,  quality  health  care  for  marginalized  popula.ons  in  Sioux  Falls,  SD.      Dr.  Bosworth  is  cer.fied  to  provide  not  only  general  prac.ce  services  but  also  a  recognized  expert  in  nutri.on,  exercise  and  mental  condi.oning  programs.    She  is  also  the   founder   of   ECHO   Kids  a   local   ini.a.ve   that   is   aimed   at   reducing   childhood  obesity   and   lowering  childhood  rates  of  diabetes.      Dr.  Bosworth  is  involved  in  helping  reform  healthcare  around  the  globe.  She  was   recently   in   Hai.,   heading   several   medical  mission   trips  providing   necessary   services   to   rural   and  urban  areas.    Dr.  Bosworth  is  blessed  to  share  her  life  with  her  husband,  Chad,  and  their  three  children.

Ma_hew  D.  Jahraus,  MD,  ACP  Member,  has  been  in  prac.ce  at  Sanford  USD  Medical  Center  for  2   years  with   the   Sanford   Clinic   Hospitalist   group.   He  is  an  Assistant   Clinical  Professor   at   the  Sanford   School  of   Medicine  at   the  University   of   South   Dakota.   He   is  ac.ve  in   both  medical  student  and  resident  educa.on  on  the  hospitalist   teaching  service.  His  areas  of  interest  include  peri-­‐opera.ve  medicine  and  pa.ent  educa.on.    Dr.   Jahraus  received  his  medical  degree  from  Midwestern   University-­‐Chicago   College   of   Osteopathic   Medicine   and   completed   his   Internal  Medicine  residency   at   the  University  of  Nebraska  Medical  Center.  He  currently  resides  in  Sioux  Falls  with  his  wife  Allison  and  two  sons.  

Mark  G.  Lounsbery,  DO,  ACP  Member,  is  a  2005  graduate  of  Des  Moines  University  and  a  na.ve  of  Beresford,  South  Dakota.  He  is  currently   an  Internal  Medicine  Physician  at  The  Sanford  Adult  Medicine  Clinic.  Dr.   Lounsbery   has  been  a  member  of  the  American  College  of  Physicians  since  2008.  He  also  is  a  member  of  the  South  Dakota  State  Medical  Associa.on,  as  well  as,  serving  as  Clinical  Faculty  at  The  Sanford  School  of  Medicine  of  The  University  of  South  Dakota  since  2005.  In  his  free  .me  he  enjoys  spending  .me  with  his  family   and  genng  in  a  round  or   two  of  golf  when  possible.

FACULTY:Brandon   L.   Allard,   MD,  has  been  in  prac.ce  at   Sanford  USD  Medical  Center   for   8   years  as  a  clinical  endocrinologist.  He  is  an  Assistant  Clinical  Professor  at  the  Sanford  School  of  Medicine  at  the  University   of  South  Dakota.    Dr.  Allard  received  his  medical  degree  from  the  University  of  Minnesota  Medical  School,  completed  Internal  Medicine  residency  at  AbboY  Northwestern,  and  completed  a  3  year  Endocrine  Fellowship  at  the  Mayo  Clinic.  He  lives  in  Sioux  Falls  with  his  wife  and  two  children.  

Joann   Benne_,   MD   is   a   Board   Cer.fied   Internal  Medicine   Physician   with   Subspecialty   in  Pulmonary   Medicine   and   Hospice   &   Pallia.ve   Medicine.     In   addi.on,   she   has   had   the  opportunity  to  work  in  the  Avera  eICU  as  a  virtual  Intensivist.    Dr.  BenneY  has  prac.ced  in  the  Sioux   Falls  area  for   11   years.     She  is  an  Associate  Professor  of  Medicine  at  Sanford  School  of  Medicine.    Her  enthusiasm  for  educa.on  and  holis.c  medical  prac.ce  are  apparent  in  her  work  .

Thomas  M.   Braithwaite,   MD,   FACP   is   the   current   Governor   of   the  South   Dakota  ACP.     He  graduated   Augustana  College   in   1978   and   Sanford  USD  School  of  Medicine   in   1982.     From  1982-­‐85  he  did  his  Internal  Medicine  residency  at  University  of  Iowa  Hospitals  and  Clinics  in  Iowa  City,  IA.    Dr.  Braithwaite  then  prac.ced  general  Internal  Medicine  from  1985  to  2003  at  Sanford  Health  in  Sioux  Falls,  SD.    He  stayed  at  Sanford  Health  as  a  Hospitalist  from  2003  to  2010  and  is  now  Chief   Quality   Officer.     Along  with  his  wife  Tacey,   they   have   two   children.     His  interests  include  music,  running,  and  reading.

Jeremy  M.  Cauwels,  MD,  FACP  was  born  in  Viborg,  SD  in  1976.    He  grew  up  in  Hawarden,  IA,  and  aYended  the  University  of  Northern  Iowa.    Medical  School  was  at  the  University  of  Iowa  College  of  Medicine,  and  Residency  was  at  the  University  of  Kansas  where  he  was  selected  to  be  Chief  Resident.     He  returned  to  Sioux   Falls  6  years  ago,   and  has  been  a  Hospitalist   at   Sanford  USD  Medical  Center  since.

Bob  Doherty  is  Senior  Vice  President  of  Governmental  Affairs  and  Public  Policy  for   the  American  College  of  Physicians  (ACP),   the   largest   physician  specialty   society   and   second  largest   medical  organiza.on   in   the   U.S.   ACP   represents   130,000   internal   medicine   physicians   and   medical  students.    Mr.   Doherty   has  over   31   years  of   health  policy   experience  and  is  an   accomplished  presenter   at   health  conferences.     From  1979   to   1998,   he  worked   in   the  governmental  affairs  department  of  the  American  Society  of  Internal  Medicine,  and  with  the  merger  of  ASIM  and  ACP  in  June,  1998,  joined  the  ACP  as  Senior  Vice  President  for  Governmental  Affairs  and  Public  Policy.    

LuAnn   M.   Eidsness,   MD,   FACP   aYended  medical  school  and   completed   her   Internal  Medicine  Residency   at   Sanford   School  of   Medicine.   She   joined   SSOM   in   1990   and   is  now   Chair   of   the  Department.   She   teaches   biomedical   ethics   and   hospice/pallia.ve   medicine   (HPM)   to   the  students  and  residents.   She  is  board   cer.fied   in   both   internal  medicine  and  hospice/pallia.ve  medicine.  She  is  the  medical  director  of  Ethics  and  HPM  at  Sanford  Health  in  Sioux  Falls.

Hesham  M.  Elgouhari,  MD,  FACP  is  the  medical  director  of  the  Avera  Medical  Group  Liver  Disease  center   in   Sioux   Falls,   SD.     Dr.   Elgouhari   completed   his   fellowship   in   Hepatology/Transplant  Hepatology  at  the  Cleveland  Clinic  in  Cleveland,  OH.    He  has  also  completed  an  Infec.ous  Disease  fellowship  at  the  University  of  New  Mexico  in  Albuquerque,  NM.    Dr.  Elgouhari  is  board  cer.fied  in  Internal  Medicine  and  Infec.ous  Disease.    His  special  interests  include  Transplant  Hepatology,  viral  hepa..s,  autoimmune  and  metabolic  liver  disease.

Jorge  A.  Gilbert,  MD  has  been  in  clinical  prac.ce  at   Sanford  Health  for   12   years.  He  is  an  ac.ve  member  of  the  medical  staff  at  Sanford  USD  Medical  Center,  and  is  an  Associate  Clinical  Professor  at   the  Sanford  School  of  Medicine  at  the  University   of  South  Dakota.  Always  the  teacher,  he  is  highly   regarded  as  a  technically   superior   endoscopist,   and   is  a  favorite  amongst   students  and  residents  alike.   He  is  widely   respected  for   his  knowledge  of   the  care  and  treatment   of  the  full  range  of   GI  problems  including  hepatology   and  pancrea.co-­‐biliary   concerns  along  with  a  large  endoscopy   prac.ce.   Dr.   Gilbert   received   his  medical   training   at   pres.gious   academic   medical  centers  including  Harvard,  MassachuseYs  General  Hospital,  and  the  Mayo  School  of  Medicine.  A  na.ve  of  Ecuador,  he  resides  in  Sioux  Falls  with  his  wife  and  two  daughters.”

FACULTY:

Richard   P.   Holm,   MD,   FACP   is   an   outpa.ent   and   hospital   internist   prac.cing   30+   years   in  Brookings.  His  interests  in  medicine  include  the  general  broad  sweep  of  diagnos.c  and  therapeu.c  problems   adults   and   elderly   encounter   living   on   the   prairie.   He   performs   colonoscopy,  echocardiography,  and  an.cipates  developing  some  exper.se  in  teaching  hand  held  ultrasound  for  the  generalist.    For   the  past  10   years,  Dr.   Holm  has  been  medical  director   of  the  PBS  television  program  OnCall.     In  2011,   he  and  his  wife  Joanie   founded  Healing   Words  Founda.on,   whose  mission   is   to   enhance   health   and   diminish   suffering   through   the   communica.on   of   useful  informa.on,  based  on  honest  science,  provided  in  a  respecqul  and  compassionate  manner.

Jennifer   L.   Hsu,  MD,  ACP   Member,   aYended  medical  school  at   the  University   of  Missouri  and  completed  residency  and  fellowship  training  in  Infec.ous  Disease  at  the  University  of  Wisconsin.  AXer   fellowship,   she  was   on   the  University   of   Wisconsin   faculty   before   taking   a   posi.on   at  Sanford  Health.  Dr.  Hsu  is  ac.ve  in  an.bio.c  stewardship  and  infec.on  control  within  the  Sanford  Health   system   and   also   par.cipates  ac.vely   in   medical   educa.on   ini.a.ves  at   Sanford  USD  School  of  Medicine.  In  her  free  .me,  she  enjoys  hiking,  traveling,  and  cooking.

Chris?na   E.   Lankhorst,   MD,   ACP   Member   grew   up   in  Sioux   Falls,   SD   and   aYended  Medical  School  at   Case  Western  Reserve  University.     She   completed  her   residency   and  fellowship   at  University   Hospitals  Case  Medical  Center.    Dr.  Lankhorst  is  board  cer.fied  in  Internal  Medicine,  Nephrology,  and  most  recently   became  a  Cer.fied  Hypertension  Specialist.     She  joined  Sanford  Nephrology   Clinic  in  August  2010  and  is  ac.vely   involved  with  the  Na.onal  Kidney   Founda.on  and  now  the  American  College  of  Physicians.    Outside  of  work  Dr.   Lankhorst  enjoys  spending  .me  with  her   family.     Recently,   she  and  her  husband  Trent  welcomed  a  new  addi.on  to  their  

Nate   J.   Miller,  MD,   ACP  Member,   aYended  medical  school  and  did  his  residency   at   Sanford  School  of  Medicine  at  the  University   of  South  Dakota.    Dr.  Miller  was  chief  resident  un.l  June  2012   and   is  currently   a  hospitalist   at   Avera  McKennan  and   is  ac.vely   involved  in   the  Young  Physicians  Council  for   the  SD   ACP.     His  areas  of   interest   are  medical  educa.on   and   quality  improvement  and  he  is  also  a  member  of  the  Society  of  Hospital  Medicine.

"e reward for work well done $ % o&o'unity to do mor(

--Jonas Salk, MD

FACULTY:

Michael  P.  Pie?la,  MD,  ACP  Member,   is  board  cer.fied  in  Internal,   Cri.cal  Care  and  Pulmonary  Medicine  and  a  Fellow  of  the  American  College  of  Chest  Physicians.    He  is  an  Academic  Professor  of  Internal  Medicine  at  the  University  of  South  Dakota,  and  the  Chief  of  Staff  and  Medical  Director  of  the  ICU  at  Avera  Sacred  Heart  Hospital  in  Yankton,  SD.    He  is  also  a  member  of  the  board  of  directors  at   Sacred  Heart.     Dr.   Pie.la,   a  South   Dakota  na.ve,   aYended  medical   school  at   the  University  of  South  Dakota  and  completed  his  internship,  residency  and  fellowship  training  at  the  Mayo  Clinic  in  Rochester,  MN.    He  has  been  prac.cing  medicine  at  the  Yankton  Medical  Clinic,  P.C.  since  2006.

Donna  E.  Sweet,  MD,  MACP,  is  a  Professor  of  Internal  Medicine  at  the  University  of  Kansas  School  of   Medicine-­‐Wichita,   KS.     She   is  a  Master   in   the  American   College   of   Physicians  and   is  the  Immediate  Past   Chair   of   the  American  College  of  Physicians  Founda.on  Board  as  well  as  Chair  Emeritus  of   the  American  College   of   Physicians  Board   of   Regents.     Dr.   Sweet   is  also  an  AMA  delegate  for   the  ACP   and  is  a  member   of   the  Council  on  Medical  Service  of   the  AMA.     She  is  cer.fied  as  an  HIV  specialist  by  the  American  Academy  of  HIV  Medicine  and  na.onal  Co-­‐Chair  of  the  CDC  HRSA  AIDS  Advisory  Council  (CHAC).    She  is  also  the  Principal  Inves.gator  and  Director  of  the  Kansas  AIDS  Educa.on  and  Training  Center.  

Thomas  G.   Tape,  MD,   FACP,   is  the  current   Chair   of   the  Board  of   Governors  of   the  American  College  of  Physicians  (ACP).     Dr.   Tape  has  been  a  Fellow  of   the  American  College  of  Physicians  (FACP)  since  1991.  He  has  also  recently  served  as  ACP  Governor  for  the  Nebraska  Chapter.    Board  cer.fied  in  internal  medicine,  Dr.  Tape  earned  a  bachelor’s  degree  from  Dartmouth  College  and  a  medical  degree  from  Washington  University   School  of  Medicine   in  St.   Louis.   He  completed  an  internal  medicine  residency  and  fellowship  at  the  University  of  Rochester  in  New  York.    Dr.  Tape  is  a  professor   of   internal  medicine  at   the  University   of  Nebraska  College  of  Medicine,  where  he  serves  as  chief  of   the  division  of  general  internal  medicine.    He  is  also  the  vice-­‐chair  of  clinical  affairs  of  the  department  of  internal  medicine.

PLANNING COMMITTEE:

Thomas  Braithwaite,  MD,  FACP                                            Jeremy  Cauwels,  MD,  FACP                                                Eric  Larson,  MD,  FACP

Residents Presenting Posters:

Queen Bee Mill - Sioux Falls, SD

Downtown Trolley

Pooja Aggarwal, MD, AssociateVanessa Garcia-Chen, MD, AssociateMariko Saso-Hagiwara, MD, Associate

Dilpriya Mangat, MD, AssociatePavithra Pattabiraman, MD, Associate

Troy Rowekamp, MD, AssociateThen Tong, MD, Associate

John Kelly Wachira, MD, AssociateDonald Humphrey’s Scholars’ Day Winner: John Kelly Wachira

CME ACCREDITATION:

The American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American College of Physicians designates this live activity for a maximum of ____ AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

HOTEL:Best  Western  Ramkota,  3200  W.  Maple  St.,  Sioux  Falls,  SD.

Guests  must   call  the  Ramkota   to  make   individual  reserva.ons  at:   605-­‐336-­‐0650.   PLEASE   CALL   THE   HOTEL  DIRECTLY;   SPECIAL   GROUP   RATES  AND  ROOM   BLOCK  ARE  NOT  AVAILABLE   THROUGH  THE  BEST  WESTERN  ONLINE   RESERVATIONS  SYSTEM.   AYendees  must   iden.fy   themselves  as  being  part   of  American   College   of  Physicians  Conference  to  ensure  the  special  rate.    

Hotel  room  rates  start  at  $90/night.    All  reserva?ons  must  be  received  by  8/13/02.

ExtensionsTo  accommodate  early  arrivals  and  late  departures,  group  guest   room  rates  will  be  extended  three  days  prior  and  three  days  beyond  your  scheduled  conference  date,  based  on  availability.  

HOW TO REGISTER:• If   you   need   more   informa.on   on   the   mee.ng,   please   contact   Kris   Rahm   at   605-­‐339-­‐9804   or  

[email protected]

• Registra?on  can  be  completed  by  one  of  the  following:

-­‐Faxing  the  completed  registra?on  form  to  605-­‐271-­‐9227  (no  cover  sheet  necessary)

-­‐Mailing  the  completed  registra?on  form  to:     South  Dakota  ACP,  4904  S.  Sweetbriar  Dr.,  Sioux  Falls,  SD    57108

• For  informa.on  on  College-­‐related  issues,  contact  the  South  Dakota  Chapter  Governor:     Thomas  M.  Braithwaite,  MD,  FACP   [email protected]   (605)  333-­‐6564

• Take  advantage  of  Early  Bird  fees  prior  to  August  15th.    Pre-­‐registra?ons  must  be  received  by  September  5th.     Aher   that   date,   you   must   register   on-­‐site   and   there   is   an   addi?onal   $50   fee  —save   money  by  registering  now.  

• To  access  our  online  mee.ng  informa.on  or  to  print  another  registra.on  form  for  a  friend  or  colleague,  go  to  www.acponline.org/about_acp/chapters/sd/

South Dakota ACP 2012 Registration Form

• Registration can be completed by one of the following:-Faxing the form to 605-271-9227 (no cover sheet necessary)-Mailing the form to:South Dakota ACP, 4904 S. Sweetbriar Dr., Sioux Falls, SD 57108

Attendee’s Name: ___________________________________________ (MD) (DO) Credit Card Billing Address:______________________________________________

____________________________________________________________________

Phone:________________________ E-mail for receipt:_______________________

Registration Fees (PLEASE NOTE EARLY BIRD REGISTRATION):

Category – Please check one: Before 8/15/12 After 8/15/12 Amount to be Charged

ACP Member $300 $400 $Non-Member $450 $550 $ACP Resident/Student $0 $50 $

Guest Fee for Governor’s Reception and Awards BanquetGuest Name:

$75 $100 $

I wish to make a voluntary donation to support the South Dakota ACP

$

TOTAL AMOUNT DUE $

PLEASE INDICATE WHICH MEAL(S) YOU AND/OR GUEST WILL BE ATTENDING

MEAL%OR%EVENT ATTENDEE GUESTEXAMPLE X XWednesday,%September%12%–%Governor’s%Reception%%%%%%FHeld%at%Tom%Braithwaite’s%Home%%%%%%%%%%%%%%%%%%%%%%%%3705%S.%Lewis%Ct.%%%%%%%%%%%%%%%%%%%%%%%%Sioux%Falls,%SD%%%%%%%%Thursday,%September%13%F%Lunch N/AThursday,%September%13%–%Awards%BanquetFriday,%September%14%F%Fellowship%Breakfast N/AFriday,%September%14%F%Lunch N/A

CHARGE TO: _________________________________________________________ (Name as it appears on card)

_____VISA _____MC _____AMERICAN EXPRESS _____DISCOVER

CARD #_______________________________________________________________

EXP. DATE: ______________________ SECURITY CODE: ____________________ (3 digits on back or 4 digits on front of card)

SIGNATURE:___________________________________________________________

Pre-­‐registra?ons  must  be  received  by  September  5th.    Aher  that  date,  you  must  register  on-­‐site  and  there  is  an  addi?onal  $50  fee  

—save  money  by  registering  now.  

*Pleasecomplete each blank space;evenwitha zeroorN/A -- ThankYou!

--*Registrations

cannot be processed

without complete

information.